Healthcare Provider Details

I. General information

NPI: 1518926559
Provider Name (Legal Business Name): GISELA C. OKONSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2632 EDITH AVENUE, STE C
REDDING CA
96001-9600
US

IV. Provider business mailing address

2632 EDITH AVE STE A
REDDING CA
96001-3031
US

V. Phone/Fax

Practice location:
  • Phone: 530-247-0404
  • Fax: 530-247-0472
Mailing address:
  • Phone: 530-247-0404
  • Fax: 530-247-0472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA46125
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA46125
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: