Healthcare Provider Details

I. General information

NPI: 1376947978
Provider Name (Legal Business Name): HAYES B. GLADSTONE, MD, PC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2014
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 BLACKHAWK RD STE 140
DANVILLE CA
94506-4832
US

IV. Provider business mailing address

3860 BLACKHAWK RD STE 140
DANVILLE CA
94506-4832
US

V. Phone/Fax

Practice location:
  • Phone: 925-837-6000
  • Fax:
Mailing address:
  • Phone: 925-837-6000
  • Fax: 925-837-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HAYES B GLADSTONE
Title or Position: PRESIDENT
Credential: MD
Phone: 925-837-6000