Healthcare Provider Details

I. General information

NPI: 1346637949
Provider Name (Legal Business Name): HENRY MARKLEY GASS IV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14642 NEWPORT AVE STE 105
TUSTIN CA
92780-6058
US

IV. Provider business mailing address

14642 NEWPORT AVE STE 105
TUSTIN CA
92780-6058
US

V. Phone/Fax

Practice location:
  • Phone: 949-688-0958
  • Fax: 949-688-0960
Mailing address:
  • Phone: 949-688-0958
  • Fax: 949-688-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA201942
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: