Active NPI
Gregory Allen O Gunn, PA-C
- Physician Assistant
- La Mesa, CA
National Provider Identifier
1790971992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA19343
- Practice address
- 5555 Grossmont Center Dr
La Mesa, CA 91942-3019 - Phone
- (619) 740-5014
- Fax
- (619) 740-4213
- NPI assigned
- Sep 20, 2007
- Last updated
- Mar 23, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA19343 | CA | Primary |
Addresses
Primary practice location
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Mailing address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone (619) 740-5014
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA19343 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gunn Family Consulting | Current | Accepting new patients | |
| San Diego Cardiac Center Medical Group Inc | Past | Accepting new patients |
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.
-
dba Homewatch Caregivers of Central San Diego
- In Home Supportive Care Agency
- San Diego, CA
- NPI 1700714425
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- San Diego, CA
- NPI 1790766038
-
- Cardiovascular Disease Physician
- San Diego, CA
- NPI 1801980446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490227200000",
"number": "1790971992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 GROSSMONT CENTER DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423019",
"telephone_number": "619-740-5014",
"fax_number": "619-740-4213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 GROSSMONT CENTER DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423019",
"telephone_number": "619-740-5014",
"fax_number": "619-740-4213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNN",
"first_name": "GREGORY ALLEN",
"middle_name": "O",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-20",
"last_updated": "2017-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA19343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.