Dwight David Gaggero, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G58937 Issued in CA

Practice address

3460 Glendora Dr
San Mateo, CA 94403-3943

Phone

(650) 759-2687

Fax

(650) 572-9654

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: dgaggero14186@alamedahs.direct-ci.com

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1366433153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 GLENDORA DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944033943",
            "telephone_number": "650-759-2687",
            "fax_number": "650-572-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 GLENDORA DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944033943",
            "telephone_number": "650-759-2687",
            "fax_number": "650-572-9654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGGERO",
        "first_name": "DWIGHT",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G58937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G589370",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G589370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Fung, LAC
• Tracey M Fung, D.C.
• Madelynne Rae Gabriele
• Raymond R Gaeta, M.D.
• Robin Staci Gaffke Villavicencio, BA, ATC
• Dorcas Gaines
• Monteze Lee Gaines
• Jimena Galanis
• Victoria Galanter, NP
• Angela Galatierra-Ganding, L.AC.

• Emergency Medicine Physician in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.