MEDICARE: GEARHART/ARAJ SURGEONS MEDICAL GROUP, A PROFESSIONAL CORPORATION

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	208600000X	Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ19780Z	OTHER	CA	BLUE SHIELD OF CA GROUP #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932129715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEARHART/ARAJ SURGEONS MEDICAL GROUP, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	1900 MOWRY AVE
Second Line	:	SUITE 404
City	:	FREMONT
State	:	CA
Zip	:	94538-1722
Country	:	US
Telephone Number	:	510-797-1770
Fax Number	:	510-797-2040

Provider Business Practice Location Address
First Line	:	1900 MOWRY AVE
Second Line	:	SUITE 404
City	:	FREMONT
State	:	CA
Zip	:	94538-1722
Country	:	US
Telephone Number	:	510-797-1770
Fax Number	:	510-797-2040

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RAMSEY A ARAJ
Credential	:	MD
Telephone Number	:	510-979-1770

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	08/07/2008

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