Individual provider Active NPI

John W. Gallo, DO

  • Internal Medicine Physician
  • Pittsburg, CA
National Provider Identifier
1558446229
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A7460 Issued in CA
Practice address
2220 Gladstone Dr
Ste 3
Pittsburg, CA 94565-5123
Phone
(925) 432-3318
Fax
(925) 432-4590
NPI assigned
Oct 25, 2006
Last updated
Jul 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A7460 CA Primary

Addresses

Primary practice location

2220 Gladstone Dr
Ste 3
Pittsburg, CA 94565-5123

Mailing address

2220 Gladstone Dr Ste 3
Pittsburg, CA 94565-5123
Phone (925) 432-3318

Other identifiers 1

IdentifierTypeStateIssuer
00AX74600MedicaidCA

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
I20110415000698 CA Practitioner - Internal Medicine 2769666759 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7460CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pittsburg-Antioch Medical Group a Professional Corporation Internal Medicine CurrentSince Jul 12, 2016 Accepting new patients

Locations

2400 Balfour Rd
Ste 306
Brentwood, CA 94513
Phone (925) 432-3318

2220 Gladstone Dr
Ste 3
Pittsburg, CA 94565
Phone (925) 432-3318

Organizations & group practices 1

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1558446229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 GLADSTONE DR STE 3",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945655123",
            "telephone_number": "925-432-3318",
            "fax_number": "925-432-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 GLADSTONE DR",
            "address_2": "STE 3",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945655123",
            "telephone_number": "925-432-3318",
            "fax_number": "925-432-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "JOHN",
        "middle_name": "W.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX74600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, CA

Sources for this page

Verify at the official NPI Registry.