Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Glenn Eric Gifford, PA-C

Individual provider Physician Assistant · NPI 1205011475

Glenn Eric Gifford, PA-C is a Physician Assistant in Ukiah, California. Qualified in 2006, 20 years ago. Practices with Mendocino Community Health Clinic Inc, a 58-clinician group and accepts Medicare assignment. Licensed in California and Pennsylvania.

Years since qualifying
20
Licensed in
CA, PA
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

333 Laws Ave
Ukiah, CA 95482-6540
Phone: (707) 468-1010
Fax: (707) 462-7532
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 61224 (CA)
Physician Assistant Taxonomy 363A00000X · Licence MA053012 (PA)

Record details

NPI number1205011475
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 7, 2008
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Mendocino Community Health Clinic Inc — 58 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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