Healthcare Provider Details

I. General information

NPI: 1609921816
Provider Name (Legal Business Name): DONALD J GASPARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DONALD J GASPARD M.D.

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CALIFORNIA BLVD TRAUMA SERVICES
PASADENA CA
91105-3010
US

IV. Provider business mailing address

100 W CALIFORNIA BLVD TRAUMA SERVICES
PASADENA CA
91105-3010
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-5900
  • Fax:
Mailing address:
  • Phone: 626-397-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberG7031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: