Individual provider Active NPI

Gary MC Calla, M.D.

  • Emergency Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1669416285
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G72049 Issued in CA
Practice address
1165 Montgomery Drive
Santa Rosa Memorial Hospital
Santa Rosa, CA 95405-4897
Phone
(707) 522-1573
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G72049 CA Primary

Addresses

Primary practice location

1165 Montgomery Drive
Santa Rosa Memorial Hospital
Santa Rosa, CA 95405-4897

Mailing address

451 Aviation Blvd Ste 201
Santa Rosa, CA 95403-1055
Phone (707) 324-2400

Other identifiers 1

IdentifierTypeStateIssuer
00G720490MedicaidCA

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
I20041109001184 CA Practitioner - Emergency Medicine 0345209540 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G72049CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine CurrentSince Nov 1, 2004 Accepting new patients
Asante Ashland Community Hospital, LLC CurrentSince Sep 15, 2018 Accepting new patients

Locations

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

280 Maple St
Ashland, OR 97520
Phone (541) 201-4000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1669416285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 AVIATION BLVD STE 201",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031055",
            "telephone_number": "707-324-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DRIVE",
            "address_2": "SANTA ROSA MEMORIAL HOSPITAL",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054897",
            "telephone_number": "707-522-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MC CALLA",
        "first_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G72049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G720490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.