Healthcare Provider Details

I. General information

NPI: 1841380524
Provider Name (Legal Business Name): BORIS GELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD SUITE 905
LONG BEACH CA
90807-3315
US

IV. Provider business mailing address

3711 LONG BEACH BLVD SUITE 905
LONG BEACH CA
90807-3315
US

V. Phone/Fax

Practice location:
  • Phone: 310-469-5111
  • Fax: 310-469-5201
Mailing address:
  • Phone: 310-469-5111
  • Fax: 310-469-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA95740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: