Healthcare Provider Details

I. General information

NPI: 1497774947
Provider Name (Legal Business Name): DAVID A GEHRET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

366 SAN MIGUEL DR STE 200
NEWPORT BEACH CA
92660-7810
US

IV. Provider business mailing address

6499 S KINGS RANCH RD STE 6
GOLD CANYON AZ
85118-2920
US

V. Phone/Fax

Practice location:
  • Phone: 949-873-6610
  • Fax:
Mailing address:
  • Phone: 949-873-6610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG48231
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG48231
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: