Healthcare Provider Details

I. General information

NPI: 1730352287
Provider Name (Legal Business Name): JEFFREY HILL GERTSCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR
SAN DIEGO CA
92103-9001
US

IV. Provider business mailing address

200 W ARBOR DR
SAN DIEGO CA
92103-9001
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-1899
  • Fax:
Mailing address:
  • Phone: 619-543-1899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA88828
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberA88828
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberA88828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: