Active NPI
Gaeton Thomas Nola, M.D.
- Plastic Surgery Physician
- Los Gatos, CA
National Provider Identifier
1629146147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- G30729
- Practice address
- 15047 Los Gatos Blvd
Ste. 150
Los Gatos, CA 95032-2054 - Phone
- (408) 356-2244
- Fax
- (408) 395-4849
- NPI assigned
- Dec 1, 2006
- Reactivated
- Apr 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | G30729 | CA | Primary |
Addresses
Primary practice location
15047 Los Gatos Blvd
Ste. 150
Los Gatos, CA 95032-2054
Mailing address
15047 Los Gatos Blvd
Ste. 150
Los Gatos, CA 95032-2054
Phone (408) 356-2244
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G30729 | CA | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1629146147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15047 LOS GATOS BLVD",
"address_2": "STE. 150",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950322054",
"telephone_number": "408-356-2244",
"fax_number": "408-395-4849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15047 LOS GATOS BLVD",
"address_2": "STE. 150",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950322054",
"telephone_number": "408-356-2244",
"fax_number": "408-395-4849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLA",
"first_name": "GAETON",
"middle_name": "THOMAS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2011-04-05",
"deactivation_date": "2007-03-13",
"reactivation_date": "2008-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CA",
"license": "G30729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.