Active NPI
Boxidara, Inc.
- Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
- Palmdale, CA
National Provider Identifier
1811289317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
- License
- G67090
- Legal business name
- BOXIDARA, INC.
- Practice address
- 38660 Medical Center Dr Ste A150
C/O Palmdale Med. Ctr. Wound Care Clinic
Palmdale, CA 93551-4385 - Phone
- (818) 709-8161
- Fax
- (818) 709-8160
- NPI assigned
- May 3, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John S Gambol, M.D.
- Title
- President
- Phone
- (818) 709-8161
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Undersea and Hyperbaric Medicine (Emergency Medicine) Physician | 207PE0005X | G67090 | CA | Primary |
Addresses
Primary practice location
38660 Medical Center Dr Ste A150
C/O Palmdale Med. Ctr. Wound Care Clinic
Palmdale, CA 93551-4385
Mailing address
PO Box 9126
Canoga Park, CA 91309-0126
Phone (818) 709-8161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
38660 Medical Center Dr
Ste A150
Palmdale, CA 93551
Phone (661) 945-5571
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
- Placentia, CA
- NPI 1255339826
-
- Medical Physician Assistant
- Santa Clarita, CA
- NPI 1104076660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529452800000",
"number": "1811289317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9126",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913090126",
"telephone_number": "818-709-8161",
"fax_number": "818-709-8160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38660 MEDICAL CENTER DR STE A150",
"address_2": "C/O PALMDALE MED. CTR. WOUND CARE CLINIC",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935514385",
"telephone_number": "818-709-8161",
"fax_number": "818-709-8160"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BOXIDARA, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2011-05-03",
"last_updated": "2018-06-20",
"status": "A",
"authorized_official_last_name": "GAMBOL",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "818-709-8161",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207PE0005X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
"state": "CA",
"license": "G67090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.