GREGORY GULLO MD PC (NPI# 1124105044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124105044 |
| Entity Type | Organization |
| Organization Name | GREGORY GULLO MD PC |
| Other Organization Name | INTEGRATED SPINE CARE |
| Practice Address |
24076 Se Stark St Suite 320 Gresham OR 97030-3373 |
| Practice Telephone | 5035121212 |
| Practice Fax Number | 5035121220 |
| Mailing Telephone | 5035121212 |
| Mailing Fax Number | 5035121220 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GREGORY GULLO (PRESIDENT) |
| Authorized Official Telephone | 5035121212 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
MD26192 | OR | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Integrated Spine Care | Doing Business As Name - Organization |
| Street Address |
24076 SE STARK ST SUITE 320 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070873 | Shammai Rockove | Urology | 24076 Se Stark St, Suite 310, Gresham, OR 97030-3373 | 2005-08-16 |
| 1538659578 | Claire Valentine | Physical Therapist | 24076 Se Stark St, Gresham, OR 97030 | 2018-05-15 |
| 1598289282 | Stephen Matthew Block | Physical Therapist | 24076 Se Stark St, Gresham, OR 97030-3373 | 2017-08-03 |
| 1114479458 | Anna Lee | Physician Assistant | 24076 Se Stark St, Suite 230, Gresham, OR 97030-3373 | 2016-11-03 |
| 1265801070 | Patrick Clinton | Physical Therapist | 24076 Se Stark St, Suite 200, Gresham, OR 97030-3373 | 2015-09-22 |
| 1932548161 | Jenna Lee Esterberg | Physician Assistant | 24076 Se Stark St, Suite 230, Gresham, OR 97030-3373 | 2013-06-20 |
| 1922371947 | Armworks Hand Therapy, LLC | Durable Medical Equipment & Medical Supplies | 24076 Se Stark St, Suite 200, Gresham, OR 97030-3373 | 2012-02-22 |
| 1225311210 | Shelley Piers-vanderploeg | Physical Therapist | 24076 Se Stark St, Suite 200, Gresham, OR 97030-3373 | 2011-09-26 |
| 1932497518 | Christina Doughty | Physician Assistant | 24076 Se Stark St, Suite 110, Gresham, OR 97030-3373 | 2011-07-15 |
| 1205130473 | Jennifer Robyn Briggs | Audiologist | 24076 Se Stark St, Suite 230, Gresham, OR 97030-3373 | 2011-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992798169 | Timothy L Kelly | Anesthesiology | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2005-08-23 |
| 1841238128 | Nhat Quang Nguyen | Anesthesiology | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912346461 | Vishal Khemlani | Anesthesiology | 6464 Sw Borland Rd Ste A2, Tualatin, OR 97062-8854 | 2013-06-18 |
| 1316140965 | Russell Robert Kinder | Anesthesiology | 10000 Se Main St Ste 128, Portland, OR 97216-2462 | 2007-06-08 |
| 1124075791 | Gregory Gullo | Anesthesiology | 2020 8th Ave, Suite 200, West Linn, OR 97068-4657 | 2006-05-28 |
| 1851353502 | Ahmed Ebeid | Anesthesiology | 851 Ne Baker St Ste 1, Mcminnville, OR 97128-4991 | 2006-04-06 |
| 1013911361 | Brett T Quave | Anesthesiology | 701 Golf View Dr, Medford, OR 97504-9643 | 2005-06-01 |
| 1568083517 | Deschutes Pain Specialists LLC | Anesthesiology | 2235 Nw Shevlin Park Rd Ste 100, Bend, OR 97703-7111 | 2020-04-30 |
| 1942675467 | Pain Care Specialists of Oregon, LLC | Anesthesiology | 2480 Liberty St Ne Ste 180, Salem, OR 97301-8388 | 2015-12-09 |
| 1487023388 | Comprehensive Pain Care, LLC | Anesthesiology | 842 E Main St, Medford, OR 97504-7134 | 2015-09-21 |
| 1235520503 | Andrew Oh Md PC | Anesthesiology | 140 Nw 14th Ave, Portland, OR 97209-2601 | 2015-02-09 |
| 1558751958 | Washington Center for Pain Management LLC | Anesthesiology | 11786 Sw Barnes Rd, Suite 270, Portland, OR 97225-5929 | 2015-01-23 |
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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.