GARY NICHOLS


Address: 2455 Summerfield Rd, Santa Rosa, CA 95405
Phone: 7073082815

GARY NICHOLS (NPI# 1033201587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033201587
Entity Type Individual
Full Name GARY NICHOLS
Credential M.D.
Practice Address 2455 Summerfield Rd
Santa Rosa
CA 95405
Mailing Address 325 Distel Cir
Los Altos
CA 94022-1408
Practice Telephone 7073082815
Practice Fax Number 7075735439
Mailing Telephone 7073082815
Mailing Fax Number 7075735439
Enumeration Date 2006-09-29
Last Update Date 2019-07-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine G73872 CA Allopathic & Osteopathic Physicians
N 207RH0000X Internal Medicine
Specialization: Hematology
181851 CA Allopathic & Osteopathic Physicians
N 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
181851 CA Allopathic & Osteopathic Physicians
N 207RX0202X Internal Medicine
Specialization: Medical Oncology
181851 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PTAN CP059Z 01
CA STATE MEDICAL LICENSE G73872 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
3883 Airway Dr, Suite 201, Santa Rosa, CA 954031670 7075218900 7075231309

Other Providers GARY NICHOLS

NPI Name Taxonomy Address Enumeration
1528314713 Gary W Nichols Counselor 5150 E Stop 11 Rd Ste 10, Indianapolis, IN 46237-8629 2012-07-25
1437140357 Gary Dale Nichols Physician Assistant 16th Street, Ctmc, Bldg 885, Fort Leonard Wood, MO 65473 2005-10-31
1316936156 Gary Glenn Nichols Physician Assistant 1404 Willow Ln, North Wilkesboro, NC 28659-3584 2005-10-14
1477580132 Gary Lee Nichols Social Worker 3250 Zemke Ave, Tampa, FL 33621-5023 2006-06-27
1386612141 Gary E. Nichols Pediatrics 2855 Campus Dr, #350, Plymouth, MN 55441-2649 2006-03-09
1891781803 Gary A Nichols Family Medicine 3 E Benjamin Dr, New Martinsville, WV 26155-2705 2005-09-26

Office Location

Street Address 2455 SUMMERFIELD RD
City SANTA ROSA
State CA
Zip Code 95405

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538167226 Wendy A Williams Physician Assistant 2455 Summerfield Rd, Santa Rosa, CA 95405-7815 2005-07-07
1538688858 Christine E Silano Nurse Practitioner 2455 Summerfield Rd, Santa Rosa, CA 95405 2017-09-18
1760764641 Julia L. Leonardi-holzapfel Social Worker 2455 Summerfield Rd, Santa Rosa, CA 95405 2011-09-15
1134446875 Charlotte Mary Carlson Internal Medicine 2455 Summerfield Rd, Santa Rosa, CA 95405-7815 2010-04-20
1598889636 Sutter Medical Group of The Redwoods Family Medicine 2455 Summerfield Rd, Santa Rosa, CA 95405-7815 2007-03-16
1144281635 Gary Neal Furness Family Medicine 2455 Summerfield Rd, Santa Rosa, CA 95405-7815 2006-04-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083230486 Lizett Camacho Counselor 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 2020-06-22
1346768918 Ingrid Tsong Student in an Organized Health Care Education/Training Program 3447 Summerfield Road, Santa Rosa, CA 95405 2017-09-05
1275051898 Jessica Peters Malmberg Student in an Organized Health Care Education/Training Program 2447 Summerfield Rd, Santa Rosa, CA 95405 2017-09-04
1306246772 Kirsten Eckert Advanced Practice Midwife 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 2014-09-03
1982034294 Mohammad Reza Saeidi Dentist 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 2013-11-22
1851631642 Debi M. Emmons Marriage & Family Therapist 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 2013-02-15
1841549979 Karie Louise Klim Marriage & Family Therapist 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 2012-09-05
1427314400 Rachel E. Page Counselor 2447 Summerfield Rd., Santa Rosa, CA 95405 2012-04-04
1689991572 Center for Integral Healing Inc. Community Health Worker 182 Farmers Lane, #203, Santa Rosa, CA 95405 2010-04-30
1588997647 Kai Morgan Dentist 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 2009-09-08
Find all providers in zip 95405

Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1922640820 Northern California Medical Assoc Inc Internal Medicine 830 2nd St Ste A, Santa Rosa, CA 95404-4620 2019-10-11
1457613275 Shelleen E. Denno, Md, Inc. Internal Medicine 2285 Olivet Ln, Santa Rosa, CA 95401-3860 2012-06-08
1043509920 Ann Katz Press Internal Medicine 30 Mark West Springs Rd Ofc, Santa Rosa, CA 95403-1436 2011-03-31
1376786947 Jaya Reddy Mallidi Internal Medicine 500 Doyle Park Dr Ste G05, Santa Rosa, CA 95405-4555 2009-04-13
1003072851 Sutter Medical Group of The Redwoods Internal Medicine 4725a Hoen Ave, Santa Rosa, CA 95405-7862 2008-07-31
1639355266 North Coast Hospitalist, PC Internal Medicine 122 Calistoga Rd, 305, Santa Rosa, CA 95409-3702 2008-01-14
1932388659 Jennifer Nguyen Hubert, D.o., Inc Internal Medicine 1014 Hopper Ave, # 615, Santa Rosa, CA 95403-1613 2007-10-30
1144412560 Zeyad Hashem Kanaan Internal Medicine 3883 Airway Dr Ste 220, Santa Rosa, CA 95403 2007-08-10
1447451935 Todd Jay Hofeling Internal Medicine 3883 Airway Dr Ste 130, Santa Rosa, CA 95403 2007-05-30
1932244779 John Mcdougall Internal Medicine 2777 4th St, Santa Rosa, CA 95405-4795 2007-02-20
Find all providers in SANTA ROSA

Competitor

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City SANTA ROSA
Zip Code 95405

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Dataset Information

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.

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