JOHN GALLO MD NPI 1225049257

NPI Information

NPI: 1225049257
Provider Name: JOHN GALLO, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
721 RIVER DR
SUITE A
FORT BRAGG, CA
ZIP 95437
Phone: (707) 961-4631
Get Directions

John Gallo, MD is a family medicine in Fort Bragg, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. John Gallo, MD NPI is 1225049257. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

721 RIVER DR
SUITE A
FORT BRAGG, CA
ZIP 95437
Phone: (707) 961-4631
Fax: (707) 964-1192

The NPI 1225049257 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/11/2006 and was last updated on 10/16/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		C36010	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A36137	MEDICARE UPIN	CALIFORNIA
2	00C360100	OTHER	CALIFORNIA	MEDI-CAL
3	00C360100	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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