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NPI Code Detail

MEDICARE: DR. GARY GERSHONY M.D.

MEDICARE: DR. GARY GERSHONY 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
1207RI0011XInterventional Cardiology PhysicianG47523CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01474763OTHERCAMEDICARE RAILROAD

General Provider Information

NPI Number : 1821095134
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY GERSHONY M.D.
Provider Business Mailing Address
First Line : 315 PERSHING DR
Second Line :
City : OAKLAND
State : CA
Zip : 94611-3236
Country : US
Telephone Number : 925-408-7252
Fax Number : 510-601-0433
Provider Business Practice Location Address
First Line : 2540 EAST ST
Second Line :
City : CONCORD
State : CA
Zip : 94520-1906
Country : US
Telephone Number : 925-408-7252
Fax Number : 510-601-0433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 01/19/2020

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