Individual provider Active NPI

John C Gunnell

  • Hematology & Oncology Physician
  • Glendale, CA
National Provider Identifier
1487765301
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
G17573 Issued in CA
Practice address
435 Arden Ave Ste 520
Glendale, CA 91203
Phone
(818) 247-5440
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X G17573 CA Primary

Addresses

Primary practice location

435 Arden Ave Ste 520
Glendale, CA 91203

Mailing address

435 Arden Ave Ste 520
Glendale, CA 91203-1138
Phone (818) 247-5440

Other identifiers 1

IdentifierTypeStateIssuer
00G175730MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110105000875 CA Practitioner - Hematology/Oncology 8628267762 Practice locations: Glendale, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G17573CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health System - Southern California Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1487765301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 ARDEN AVE STE 520",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031138",
            "telephone_number": "818-247-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 ARDEN AVE STE 520",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91203",
            "telephone_number": "818-247-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNNELL",
        "first_name": "JOHN",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G17573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G175730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.