Active NPI
Nazema Gosla, PA
- Physician Assistant
- Tustin, CA
National Provider Identifier
1659493674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA15465
- Practice address
- 13152 Newport Ave
Tustin, CA 92780 - Phone
- (714) 442-4864
- Fax
- (714) 442-4892
- NPI assigned
- Apr 3, 2007
- Last updated
- Feb 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA15465 | CA | Primary |
Addresses
Primary practice location
13152 Newport Ave
Tustin, CA 92780
Mailing address
1665 Scenic Ave. Suite 100
Costa Mesa, CA 92626
Phone (714) 442-4864
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA15465 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davita Medical Group Talbert California, P.C. | Past | Accepting new patients | |
| Talbert Medical Group, P.C. | Past | Accepting new patients | |
| Talbert Medical Group, P.C. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Primary Care Clinic/Center
- San Clemente, CA
- NPI 1184836066
-
dba Talbert Medical Group
- Family Medicine Physician
- Anaheim, CA
- NPI 1477554012
-
dba Talbert Medical Group
- Internal Medicine Physician
- Fountain Valley, CA
- NPI 1528069176
-
dba Talbert Medical Group
- Family Medicine Physician
- Lakewood, CA
- NPI 1720171325
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329350400000",
"number": "1659493674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 SCENIC AVE. SUITE 100",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92626",
"telephone_number": "714-442-4864",
"fax_number": "714-442-4892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13152 NEWPORT AVE",
"city": "TUSTIN",
"state": "CA",
"postal_code": "92780",
"telephone_number": "714-442-4864",
"fax_number": "714-442-4892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSLA",
"first_name": "NAZEMA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2012-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA15465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.