Healthcare Provider Details

I. General information

NPI: 1326118282
Provider Name (Legal Business Name): DIANA GEKELMAN D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 FULTON ST
SAN FRANCISCO CA
94118-3713
US

IV. Provider business mailing address

7 VIOLET LN
SAN CARLOS CA
94070-1539
US

V. Phone/Fax

Practice location:
  • Phone: 650-430-2782
  • Fax:
Mailing address:
  • Phone: 650-430-2782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number50914
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number50914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: