Individual provider Active NPI

Gwynneth Horner

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1568996510
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A179788 Issued in CA
Practice address
UCLA OB/GYN 10833 Le Conte Ave CHS 27-126
Los Angeles, CA 90095-1702
Phone
(310) 825-9945
NPI assigned
Apr 17, 2017
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A179788 CA Primary

Addresses

Primary practice location

UCLA OB/GYN 10833 Le Conte Ave CHS 27-126
Los Angeles, CA 90095-1702

Mailing address

UCLA OB/GYN 10833 Le Conte Ave CHS 27-126
Los Angeles, CA 90095-0001
Phone (310) 825-9945

Other practice location 1

500 S Preston St Rm 305
Louisville, KY 40202-1702
Phone (502) 852-8696

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
I20230321002203 CA Practitioner - Obstetrics/Gynecology 9638409568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Louisville School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 Craven Rd
San Marcos, CA 92078-4201
Phone (619) 528-5000

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A179788CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 16, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 16, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 3

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1568996510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCLA OB/GYN 10833 LE CONTE AVE CHS 27-126",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCLA OB/GYN 10833 LE CONTE AVE CHS 27-126",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951702",
            "telephone_number": "310-825-9945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Preston St Rm 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021702",
            "country_code": "US",
            "telephone_number": "502-852-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORNER",
        "first_name": "GWYNNETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A179788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.