MEDICARE: DR. RAYMOND R GAETA 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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	G60351	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1225179823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND R GAETA M.D.

Provider Business Mailing Address
First Line	:	1900 OFARRELL ST
Second Line	:	STE 100
City	:	SAN MATEO
State	:	CA
Zip	:	94403-1386
Country	:	US
Telephone Number	:	650-645-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 OFARRELL ST
Second Line	:	STE 100
City	:	SAN MATEO
State	:	CA
Zip	:	94403-1386
Country	:	US
Telephone Number	:	650-645-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	01/12/2015

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