MEDICARE: DR. BRET ROBERT GERBER 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	208000000X	Pediatrics Physician	G79213	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	:	1952328437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRET ROBERT GERBER M.D.

Provider Business Mailing Address
First Line	:	5150 ROXBURY RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-2142
Country	:	US
Telephone Number	:	619-204-3034
Fax Number	:

Provider Business Practice Location Address
First Line	:	11770 BERNARDO PLAZA CT STE 250
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2425
Country	:	US
Telephone Number	:	858-251-3559
Fax Number	:	858-279-0377

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	10/13/2022

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