Individual provider Active NPI

Gabriel Punsalan

  • Certified Registered Nurse Anesthetist
  • Los Angeles, CA
National Provider Identifier
1770816266
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3833 Issued in CA
Practice address
1500 San Pablo St
4TH Floor
Los Angeles, CA 90033-5313
Phone
(323) 442-7400
NPI assigned
Sep 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 633318 CA
Certified Registered Nurse Anesthetist 367500000X 3833 CA Primary

Addresses

Primary practice location

1500 San Pablo St
4TH Floor
Los Angeles, CA 90033-5313

Mailing address

1500 San Pablo St
4TH Floor
Los Angeles, CA 90033-5313
Phone (323) 442-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091230000570 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163563990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University ofGroup PAC ID 8729983473, 236 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
633318CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of CurrentSince Jun 15, 2015 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1770816266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST",
            "address_2": "4TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST",
            "address_2": "4TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNSALAN",
        "first_name": "GABRIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-15",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "633318",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.