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NPI Code Detail

MEDICARE: JOHN GREGORY GAITAN M.D.

MEDICARE: JOHN GREGORY GAITAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianG74787CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124136734
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN GREGORY GAITAN M.D.
Provider Business Mailing Address
First Line : PO BOX 62106
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93160-2106
Country : US
Telephone Number : 805-681-1761
Fax Number : 805-681-1768
Provider Business Practice Location Address
First Line : 51 HITCHCOCK WAY
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-3101
Country : US
Telephone Number : 805-563-6211
Fax Number : 805-563-6220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 01/24/2019

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