Healthcare Provider Details

I. General information

NPI: 1285747352
Provider Name (Legal Business Name): DR. ARNOLD PHILIP GASS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VASDHS 3350 LA JOLLA VILLAGE DRIVE
SAN DIEGO CA
92161-0002
US

IV. Provider business mailing address

10958 IRONWOOD RD
SAN DIEGO CA
92131-1810
US

V. Phone/Fax

Practice location:
  • Phone: 858-552-7402
  • Fax: 858-642-6415
Mailing address:
  • Phone: 858-271-6427
  • Fax: 858-642-6415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberG26713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: