Individual provider Active NPI

Gwendolyn C. Okuzumi, MD

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1720164239
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A76974 Issued in CA
Practice address
1 California St Ste 2300
San Francisco, CA 94111-5424
Phone
(415) 504-3838
Fax
(415) 504-1367
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T2033 TX
Family Medicine Physician 207Q00000X ME147618 FL
Family Medicine Physician 207Q00000X MD-47866 IA
Family Medicine Physician 207Q00000X DR.0065122 CO
Family Medicine Physician 207Q00000X MD-11656 HI
Family Medicine Physician 207Q00000X 307217 NY
Family Medicine Physician 207Q00000X 61744 AZ
Family Medicine Physician 207Q00000X A76974 CA Primary
Family Medicine Physician 207Q00000X MD2020-1030 NM
Family Medicine Physician 207Q00000X 166659 AK
Family Medicine Physician 207Q00000X MD201499 OR

Addresses

Primary practice location

1 California St Ste 2300
San Francisco, CA 94111-5424

Mailing address

1 California St Ste 2300
San Francisco, CA 94111-5424
Phone (415) 504-3838

Other identifiers 1

IdentifierTypeStateIssuer
00A769740MedicaidCA

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
I20110126001064 CA Practitioner - Family Practice 3173702834 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166659AKMDFamily Medicine Physician
61744AZMDFamily Medicine Physician
A76974CAMDFamily Medicine Physician
DR.0065122COMDFamily Medicine Physician
ME147618FLMDFamily Medicine Physician
MD-11656HIMDFamily Medicine Physician
MD-47866IAMDFamily Medicine Physician
MD2020-1030NMMDFamily Medicine Physician
MD201499ORMDFamily Medicine Physician
T2033TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Family Medicine CurrentSince Nov 19, 2010 Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 19, 2010 Accepting new patients
Doctor on Demand Professionals of California Family Medicine CurrentSince Jan 1, 2021 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

275 Battery St
Ste 650
San Francisco, CA 94111
Phone 4155043838104

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

260 International Cir
San Jose, CA 95119
Phone (408) 972-6335

280 Hospital Pkwy
#C23
San Jose, CA 95119

280 Hospital Pkwy
San Jose, CA 95119
Phone (408) 972-3100

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Interoperability endpoints

  • Direct secure messaging: gwendolyn.okuzumi.1@30520.direct.athenahealth.com

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1720164239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "415-504-3838",
            "fax_number": "415-504-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "415-504-3838",
            "fax_number": "415-504-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUZUMI",
        "first_name": "GWENDOLYN",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T2033",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME147618",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-47866",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0065122",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-11656",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "307217",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "61744",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76974",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2020-1030",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "166659",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD201499",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A769740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.