Individual provider Active NPI

Gulpana M Mohammad, MD

  • Family Medicine Physician
  • Marina del Rey, CA
National Provider Identifier
1801196605
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A114460 Issued in CA
Practice address
4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424
Phone
(310) 827-3700
Fax
(310) 578-5379
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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 A114460 CA Primary

Addresses

Primary practice location

4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1301 Shoreway Rd
Suite 100
Belmont, CA 94002
Phone (650) 596-7000

Other names 1

  • Gulpana M Ansari Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20110815000615 CA Practitioner - Family Practice 3375712060 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2000

8001 Ventura Canyon Ave
Panorama City, CA 91402-6312
Phone (818) 375-2000

8033 Ventura Canyon Ave
Panorama City, CA 91402-6312
Phone (818) 375-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A114460CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Family Medicine CurrentSince Feb 17, 2015 Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Regents of the University of California Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 28, 2018 Accepting new patients
Regents of the University of California CurrentSince Apr 1, 2025 Accepting new patients
The Regents of the University of California Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
Permanente Medical Group, Inc CurrentSince Feb 17, 2015 Accepting new patients
The Regents of the University of California CurrentSince Apr 1, 2025 Accepting new patients
UC Regents Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

1000 Flower St
Glendale, CA 91201
Phone (818) 659-5000

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

File 59755
Los Angeles, CA 90074

File 55737
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

4560 Admiralty Way
Ste 100
Marina del Rey, CA 90292
Phone (310) 656-1770

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

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

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

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

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

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

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

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

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

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Interoperability endpoints

  • Direct secure messaging: gmohammad1398756@direct.uclahealth.org

Organizations & group practices 10

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": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1801196605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY STE 100",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925424",
            "telephone_number": "310-827-3700",
            "fax_number": "310-578-5379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Shoreway Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "CA",
            "postal_code": "94002",
            "country_code": "US",
            "telephone_number": "650-596-7000",
            "fax_number": "650-596-7096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMMAD",
        "first_name": "GULPANA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A114460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GULPANA",
            "last_name": "ANSARI",
            "middle_name": "M",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.