NPIMap

Organization Active NPI

Gregory L Wakeman DO Inc

Doing business as La Costa Urgent Care and Family Practice

  • Family Medicine Physician
  • Carlsbad, CA
National Provider Identifier
1669562765
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6797 Issued in CA
Legal business name
GREGORY L WAKEMAN DO INC
Doing business as
La Costa Urgent Care and Family Practice
Practice address
6971 El Camino Real
Suite 101
Carlsbad, CA 92009
Phone
(760) 603-3221
Fax
(760) 603-7719
NPI assigned
Oct 13, 2006
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Gregory Lance Wakeman, DONPI 1679663777
Title
Chief Executive Officer
Phone
(760) 603-3221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20A6797 CA Primary

Addresses

Primary practice location

6971 El Camino Real
Suite 101
Carlsbad, CA 92009

Mailing address

6971 El Camino Real
Suite 101
Carlsbad, CA 92009
Phone (760) 603-3221

Other names 1

  • La Costa Urgent Care and Family Practice Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1669562765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6971 EL CAMINO REAL",
            "address_2": "SUITE 101",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "92009",
            "telephone_number": "760-603-3221",
            "fax_number": "760-603-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6971 EL CAMINO REAL",
            "address_2": "SUITE 101",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "92009",
            "telephone_number": "760-603-3221",
            "fax_number": "760-603-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY L WAKEMAN DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "WAKEMAN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LANCE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "760-603-3221",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Costa Urgent Care and Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.