Active NPI
Gail Mona Wagner, M.D.
- Hematology & Oncology Physician
- San Leandro, CA
National Provider Identifier
1780756593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- G37771
- Practice address
- 2500 Merced Street
San Leandro, CA 94577-4201 - Phone
- (510) 454-1000
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | G37771 | CA | Primary |
Addresses
Primary practice location
2500 Merced Street
San Leandro, CA 94577-4201
Mailing address
2500 Merced Street
San Leandro, CA 94577-4201
Phone (510) 454-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G377710 | Medicaid | CA |
Other names 1
- Gail Mona Olenick
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G37771 | CA | MD | Hematology & Oncology Physician |
| 37771 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1780756593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 MERCED STREET",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774201",
"telephone_number": "510-454-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 MERCED STREET",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774201",
"telephone_number": "510-454-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "GAIL",
"middle_name": "MONA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "CA",
"license": "G37771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G377710",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GAIL",
"last_name": "OLENICK",
"middle_name": "MONA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.