Healthcare Provider Details

I. General information

NPI: 1962461046
Provider Name (Legal Business Name): JULIE A GELMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 NIPOMO ST STE 110
SAN LUIS OBISPO CA
93401
US

IV. Provider business mailing address

1023 NIPOMO ST STE 110
SAN LUIS OBISPO CA
93401-6155
US

V. Phone/Fax

Practice location:
  • Phone: 805-439-2998
  • Fax: 805-439-2997
Mailing address:
  • Phone: 805-439-2998
  • Fax: 805-439-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME69995
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberG144586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: