Healthcare Provider Details
I. General information
NPI: 1477517902
Provider Name (Legal Business Name): MICHAEL ERIC GERTNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 04/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
751 S BASCOM AVE DEPARTMENT OF SURGERY
SAN JOSE CA
95128-2604
US
IV. Provider business mailing address
131 E CREEK DR
MENLO PARK CA
94025-3606
US
V. Phone/Fax
- Phone: 408-885-5000
- Fax:
- Phone: 650-473-1752
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | A73501 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | A73501 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: