Healthcare Provider Details

I. General information

NPI: 1972901809
Provider Name (Legal Business Name): ALLYSON GELMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 ELLA ST STE B
SAN LUIS OBISPO CA
93401-4166
US

IV. Provider business mailing address

1304 ELLA ST STE B
SAN LUIS OBISPO CA
93401-4166
US

V. Phone/Fax

Practice location:
  • Phone: 805-541-6000
  • Fax: 805-541-6001
Mailing address:
  • Phone: 805-541-6000
  • Fax: 805-541-6001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA65802
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: