Healthcare Provider Details

I. General information

NPI: 1538196746
Provider Name (Legal Business Name): STEPHEN J GERBICH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 03/19/2022
Certification Date: 03/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 SISTER MARY COLUMBA DR
RED BLUFF CA
96080-4356
US

IV. Provider business mailing address

2450 SISTER MARY COLUMBA DR
RED BLUFF CA
96080-4356
US

V. Phone/Fax

Practice location:
  • Phone: 530-528-4452
  • Fax: 530-528-7921
Mailing address:
  • Phone: 530-528-4452
  • Fax: 530-528-7921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG59912
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG59912
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: