Individual provider Active NPI

Jose G Gancayco, RN

  • Critical Care Medicine Registered Nurse
  • San Diego, CA
National Provider Identifier
1831108786
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
665064 Issued in CA
Practice address
9888 Genesee Ave.
San Diego, CA 92037
Phone
(858) 678-7000
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 665064 CA Primary

Addresses

Primary practice location

9888 Genesee Ave.
San Diego, CA 92037

Mailing address

9229 Regents Rd
Unit # L225
La Jolla, CA 92037-9199
Phone (914) 625-8901

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
665064CAMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831108786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9229 REGENTS RD",
            "address_2": "UNIT # L225",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379199",
            "telephone_number": "914-625-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 GENESEE AVE.",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-678-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANCAYCO",
        "first_name": "JOSE",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "665064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.