Gastroenterology Med Assoc Cho

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

G48774 Issued in CA

Legal business name

GASTROENTEROLOGY MED ASSOC CHO

Practice address

747 52ND St
Oakland, CA 94609-1809

Phone

(510) 428-3058

Fax

(510) 450-5813

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Elizabeth Gleghorn, MD

Title

Head of Dept

Phone

(510) 428-3058

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831225101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 W MARCH LN",
            "address_2": "STE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192369",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3058",
            "fax_number": "510-450-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY MED ASSOC CHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLEGHORN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "HEAD OF DEPT",
        "authorized_official_telephone_number": "510-428-3058",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "G48774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0095830",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR GLEGHORN'S CA MD LICEN",
            "identifier": "G48774",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcus Gaskins
• Eileen Gaspar, M.D.
• Sandra Gaspar
• Heidi L. Gassner, MD
• Estefany Gastelum
• Fatima Gatchalian
• Don F Gates III, L.AC.
• Nancy Gates
• Tommiea Andrene' Gates I
• Tyler Gates

• Pediatric Gastroenterology Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Pediatric Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.