GREG GASTALDO (NPI# 1114102241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114102241 |
| Entity Type | Individual |
| Full Name | GREG GASTALDO |
| Credential | M.D. |
| Practice Address |
5500 Campanile Dr San Diego CA 92182-0001 |
| Practice Telephone | 6195942866 |
| Practice Fax Number | 6195945613 |
| Mailing Telephone | 6195942866 |
| Mailing Fax Number | 6195945613 |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | G58872 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G588720 | 05 |
| Street Address |
5500 CAMPANILE DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92182-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649206269 | Denise Ann Wiksten | Specialist/Technologist | 5500 Campanile Dr, Dept. of Exercise & Nutritional Sciences, San Diego, CA 92182-0001 | 2006-06-24 |
| 1326663840 | Lisa Marie Contois | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2020-06-10 |
| 1013547058 | Samantha Queen | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2020-01-17 |
| 1134777246 | Sara Alyson Leighanne Self | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-1680 | 2019-09-01 |
| 1033767793 | Eric Estrada | Student in an Organized Health Care Education/Training Program | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2019-08-27 |
| 1376009506 | Kyle Nicholas Llorens | Physical Therapist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2019-02-12 |
| 1336604990 | Alaina Katherine Nicholas | Student in an Organized Health Care Education/Training Program | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2019-02-07 |
| 1518431972 | Nathaniel Burns Bechtel | Student in an Organized Health Care Education/Training Program | 5500 Campanile Dr, San Diego, CA 92182-0003 | 2019-01-17 |
| 1205325065 | Queenie Soriano | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2018-05-08 |
| 1558850370 | Kristin Anne Manyak | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2018-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184137861 | Megan Lawler | Specialist/Technologist | 5032 55th Street, San Diego, CA 92182 | 2017-11-16 |
| 1548501703 | Jon Eric Alexander | Counselor | 5500 Campanile Dr., San Diego, CA 92182 | 2013-03-12 |
| 1114575875 | Rand Al Urfali | Student in an Organized Health Care Education/Training Program | 5500 Campanile Drive, San Diego, CA 92182 | 2019-08-27 |
| 1326414988 | Rachel Mahoney | Counselor | 5500 Campanile Drive, San Diego, CA 92182 | 2015-08-18 |
| 1215551551 | Jacob Riley Callahan | Specialist/Technologist | 5302 55th St, San Diego, CA 92182-0001 | 2020-06-02 |
| 1164573234 | Amol Narendra Doshi | Preventive Medicine | Sdsu Calpulli Ctr Health Svcs 5500 Campanile Dr, San Diego, CA 92182-0001 | 2007-01-16 |
| 1710973953 | Cathy Ann Baughman-gross | Nurse Practitioner | 7500 Hardy Ave, San Diego, CA 92182-0001 | 2005-09-22 |
| 1972531994 | Donald Fredrick Kessler | Specialist/Technologist | 5500 Campanille Dr, San Diego, CA 92182-4313 | 2006-06-29 |
| 1033184064 | Carolyn Rae Peters | Specialist/Technologist | 5505 Campanile Dr., Aac 1402, San Diego, CA 92182-4313 | 2006-02-22 |
| 1902443518 | Sergio Miguel Ibarra | Specialist/Technologist | 5500 Campanile Drive, San Diego, CA 92182-4313 | 2019-12-02 |
| Find all providers in zip 92182 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1487042198 | Mina Habibian Dmd Phd Dental Corporation | Clinic/Center | 11385 Poway Rd Ste 103, San Diego, CA 92128-5600 | 2015-01-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.