Wallace G Gosney MD & Gilbert R Turner MD PTRS

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G67360 Issued in CA

Legal business name

WALLACE G GOSNEY MD & GILBERT R TURNER MD PTRS

Practice address

510 N 13TH Ave Ste 204
Upland, CA 91786-4965

Phone

(909) 920-0525

Fax

(909) 920-0526

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Brian Spivack, MDNPI 1295750305

Title

Partner

Phone

(909) 946-5320

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Upland Surgical Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryce D Beseth, M.D.

  • Surgery Physician
  • Upland, CA
  • NPI 1811929243
  Medicare reassignment Care Compare group NPD
• Michael Aaron Lalezarian

  • Vascular & Interventional Radiology Physician
  • Los Angeles, CA
  • NPI 1023245230
  Medicare reassignment Care Compare group NPD
• Brian Spivack, M.D.

  • Surgery Physician
  • Rancho Cucamonga, CA
  • NPI 1295750305
  Medicare reassignment NPD Authorized official
• Donna E Dudziak, M.D.

  • Surgery Physician
  • Upland, CA
  • NPI 1275630568
  Medicare reassignment Care Compare group
• Gilbert Ray Turner, M.D.

  • Vascular Surgery Physician
  • Upland, CA
  • NPI 1407928583
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1376569657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N 13TH AVE STE 204",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864965",
            "telephone_number": "909-920-0525",
            "fax_number": "909-920-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N 13TH AVE STE 204",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864965",
            "telephone_number": "909-920-0525",
            "fax_number": "909-920-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE G GOSNEY MD & GILBERT R TURNER MD PTRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "SPIVACK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "909-946-5320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G67360",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A65402",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A65402",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "G67360",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upland Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores, Inc.
• Walgreen Co
• Walker Furman Inc
• Artinice Walker
• Randall Richard Walker, M.F.T.
• Brian Wallace
• Walmart Inc.
• Walmart Inc.
• Christine Walters
• Eileen Wang

• Surgery Physician in Upland, CA
• Providers in Upland, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.