Healthcare Provider Details

I. General information

NPI: 1356446074
Provider Name (Legal Business Name): RICHARD E GELLMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W HOSPITAL RD
FRENCH CAMP CA
95231-9693
US

IV. Provider business mailing address

1701 STERLING CT
LIVERMORE CA
94550-6031
US

V. Phone/Fax

Practice location:
  • Phone: 503-805-3267
  • Fax:
Mailing address:
  • Phone: 503-805-3267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD60925342
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberG78599
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: