Individual provider Active NPI

Gerald Francis Wahl, MD

  • Neurology Physician
  • Salinas, CA
National Provider Identifier
1174530042
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G215420 Issued in CA
Practice address
220 San Jose St
Salinas, CA 93901
Phone
(831) 424-0807
Fax
(831) 424-3408
NPI assigned
Aug 2, 2006
Last updated
Jul 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G215420 CA Primary

Addresses

Primary practice location

220 San Jose St
Salinas, CA 93901

Mailing address

220 San Jose St
Salinas, CA 93901
Phone (831) 424-0807

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ70373ZMedicaidCA
94170316793901A004OtherTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G215420CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Coast Brain and Spine Associates a Medical Corporation Current Accepting new patients
Montage Surgical Group Past Accepting new patients

Locations

220 San Jose St
Salinas, CA 93901
Phone (408) 424-0807

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1174530042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SAN JOSE ST",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "93901",
            "telephone_number": "831-424-0807",
            "fax_number": "831-424-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SAN JOSE ST",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "93901",
            "telephone_number": "831-424-0807",
            "fax_number": "831-424-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "GERALD",
        "middle_name": "FRANCIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G215420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ70373Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "94170316793901A004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.