Healthcare Provider Details

I. General information

NPI: 1720164536
Provider Name (Legal Business Name): KARNA GENDO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 05/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 LA CASA VIA BUILDING 2, SUITE 209
WALNUT CREEK CA
94598-3045
US

IV. Provider business mailing address

370 N WIGET LN STE 210
WALNUT CREEK CA
94598-2452
US

V. Phone/Fax

Practice location:
  • Phone: 925-935-6252
  • Fax: 925-930-0942
Mailing address:
  • Phone: 925-935-6252
  • Fax: 925-935-7611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD00035775
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD00035775
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA89530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: