Active NPI
Gastroenterology Specialists Medical Group, Inc a Medical Corporation
- Gastroenterology Physician
- Castro Valley, CA
National Provider Identifier
1629170998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- GASTROENTEROLOGY SPECIALISTS MEDICAL GROUP, INC A MEDICAL CORPORATION
- Practice address
- 19845 Lake Chabot Rd
Suite 104
Castro Valley, CA 94546-4055 - Phone
- (510) 537-4415
- NPI assigned
- Sep 5, 2006
- Last updated
- Aug 1, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Wei-Fang Ko Ko, M.D.
- Title
- President
- Phone
- (510) 537-4415
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
Primary practice location
19845 Lake Chabot Rd
Suite 104
Castro Valley, CA 94546-4055
Mailing address
19845 Lake Chabot Rd
Suite 104
Castro Valley, CA 94546-4055
Phone (510) 537-4415
Other names 1
- GASTROENTEROLOGY SPECIALISTS MEDICAL GROUP
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2315838 | Gastroenterology Specialists Medical Group | Compliance | Nov 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
27206 Calaroga Ave
Ste 212
Hayward, CA 94545
Phone (510) 887-1777
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Anatomic Pathology & Clinical Pathology Physician
- Los Angeles, CA
- NPI 1306047139
-
- Gastroenterology Physician
- Castro Valley, CA
- NPI 1699960815
-
- Gastroenterology Physician
- Castro Valley, CA
- NPI 1043519531
-
- Gastroenterology Physician
- Castro Valley, CA
- NPI 1417068081
-
- Gastroenterology Physician
- Castro Valley, CA
- NPI 1932325446
-
- Registered Dietitian
- Rosamond, CA
- NPI 1457060634
-
- Registered Dietitian
- Palo Alto, CA
- NPI 1548513567
-
- Registered Dietitian
- Lancaster, CA
- NPI 1780069054
-
- Gastroenterology Physician
- Castro Valley, CA
- NPI 1710098298
-
- Gastroenterology Physician
- Walnut Creek, CA
- NPI 1972500148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659312000000",
"number": "1629170998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19845 LAKE CHABOT RD",
"address_2": "SUITE 104",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945464055",
"telephone_number": "510-537-4415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19845 LAKE CHABOT RD",
"address_2": "SUITE 104",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945464055",
"telephone_number": "510-537-4415"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GASTROENTEROLOGY SPECIALISTS MEDICAL GROUP, INC A MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-05",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A",
"authorized_official_last_name": "KO",
"authorized_official_first_name": "WEI-FANG KO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "510-537-4415",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "GASTROENTEROLOGY SPECIALISTS MEDICAL GROUP",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "GASTROENTEROLOGY SPECIALISTS MEDICAL GROUP",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Castro Valley, CA
- Alma Minda Jadulang Gaite, PT
- Danahlynn Garay
- Eliana Lizeth Garcia, MD
- Gardenia Senior Care Center Inc (Lotus Residential Care)
- Gary a Osias (Primary Eyecare Optometrics)
- Bryan Gale Gatterman, D.C, D.A.C.B.R.
- Kelly Mead Gaughen, D.O.
- Michelle Gayle, LMFT
- Warren Gee, MD
- General Vascular Surgery Medical Group, Inc. (Noninvasive Vascular Lab)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.