Healthcare Provider Details

I. General information

NPI: 1326781717
Provider Name (Legal Business Name): JUANITA GYAMERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 ADAMS MILL RD NW STE C
WASHINGTON DC
20009-2399
US

IV. Provider business mailing address

1 EMBARCADERO CTR STE 1900
SAN FRANCISCO CA
94111-3723
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax:
Mailing address:
  • Phone: 415-658-6791
  • Fax: 415-252-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD600004578
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: