Individual provider Active NPI

Gaila Maureen Kenneally, DO

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1700831468
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A18171 Issued in CA
Practice address
1414 S Grand Ave Ste 380
Los Angeles, CA 90015-3072
Phone
(213) 743-9000
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A18171 CA Primary

Addresses

Primary practice location

1414 S Grand Ave Ste 380
Los Angeles, CA 90015-3072

Mailing address

1414 S Grand Ave Ste 380
Los Angeles, CA 90015-3072
Phone (213) 743-9000

Other names 1

  • Gaila Trickey Former name

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
I20210315002691 CA Practitioner - Internal MedicinePractitioner - Family Practice 7719994714 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Community ClinicGroup PAC ID 5193710275, 21 clinicians

Practice addresses (Care Compare)

1414 S Grand Ave
Los Angeles, CA 90015-3072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18171CAMDAcupuncturist
20A18171CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Urgent Care, Inc. Family Medicine CurrentSince Dec 3, 2020 Accepting new patients
Anaheim Urgent Care, Inc CurrentSince Dec 3, 2020 Accepting new patients
City of Austin Past Accepting new patients

Locations

831 S State College Blvd
Anaheim, CA 92806
Phone (714) 533-2273

1300 N La Brea Ave
Los Angeles, CA 90028
Phone (323) 464-1336

5717 Melrose Ave
Los Angeles, CA 90038
Phone (323) 957-2273

888 S Figueroa St
Ste 600
Los Angeles, CA 90017

Interoperability endpoints

  • Direct secure messaging: gaila.kenneally@avera.sdhealthlink.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1700831468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE STE 380",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153072",
            "telephone_number": "213-743-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE STE 380",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153072",
            "telephone_number": "213-743-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEALLY",
        "first_name": "GAILA",
        "middle_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A18171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAILA",
            "last_name": "TRICKEY",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.