Active NPI
Gary A Incaudo, MD
- Allergy & Immunology Physician
- Chico, CA
National Provider Identifier
1194742106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- G27753
- Practice address
- 145 Mission Ranch Blvd
Suite 110
Chico, CA 95926-2175 - Phone
- (530) 896-2200
- Fax
- (530) 896-2209
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | G27753 | CA | Primary |
| Pediatric Allergy/Immunology Physician | 2080P0201X | G27753 | CA |
Addresses
Primary practice location
145 Mission Ranch Blvd
Suite 110
Chico, CA 95926-2175
Mailing address
145 Mission Ranch Blvd
Suite 110
Chico, CA 95926-2175
Phone (530) 896-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G277530 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 27753 | CA | MD | General Practice Dentistry |
| G27753 | CA | MD | Allergy & Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263772800000",
"number": "1194742106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 MISSION RANCH BLVD",
"address_2": "SUITE 110",
"city": "CHICO",
"state": "CA",
"postal_code": "959262175",
"telephone_number": "530-896-2200",
"fax_number": "530-896-2209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 MISSION RANCH BLVD",
"address_2": "SUITE 110",
"city": "CHICO",
"state": "CA",
"postal_code": "959262175",
"telephone_number": "530-896-2200",
"fax_number": "530-896-2209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INCAUDO",
"first_name": "GARY",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2010-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "CA",
"license": "G27753",
"primary": true
},
{
"code": "2080P0201X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Allergy/Immunology",
"state": "CA",
"license": "G27753",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G277530",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chico, CA
- Richard Franklin Ickes, PTA
- Maia Alexis Illa, LCSW
- Roberto V Illa, M.D.
- Immediate Care Occupational Medicine a Professional Corporation (Integrated Therapy Services)
- Impact Speech Therapy Inc
- Innovative Health Care Services (The Peg Taylor Center for ADHC)
- Jeffrey David Inslee, LMFT
- Inspire Physical Therapy P.C.
- Inspire School of Arts & Sciences
- Integrative Massage Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.