Celso A Gangan Jr., M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD23086 Issued in OR

Practice address

1245 NW 4TH St
Ste 201
Redmond, OR 97756-1680

Phone

(541) 323-4545

Fax

(541) 323-4546

NPI assigned

Jun 21, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1598761959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 NW 4TH ST",
            "address_2": "STE 201",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561680",
            "telephone_number": "541-323-4545",
            "fax_number": "541-323-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 NW 4TH ST",
            "address_2": "STE 201",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561680",
            "telephone_number": "541-323-4545",
            "fax_number": "541-323-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGAN",
        "first_name": "CELSO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD23086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287491",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmella L Fullenwider, AG-PCNP-BC
• Lori Funk
• Brenna Fuoti
• Jessie Gallaher
• Gambee Family Dental LLC
• Kirsten Gano
• Molly Laue Garbus, M.D.
• Samuel Garbus, M.D.
• Laura E Gardiner, DC
• Megan Katherine Garland, MA, CCC-SLP

• Internal Medicine Physician in Redmond, OR
• Providers in Redmond, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.