Healthcare Provider Details

I. General information

NPI: 1871661272
Provider Name (Legal Business Name): ISABEL C GOTTRON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 01/07/2022
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 2ND ST NE
WASHINGTON DC
20002-8100
US

IV. Provider business mailing address

KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP 2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 202-346-3656
  • Fax: 202-346-3651
Mailing address:
  • Phone: 301-816-6660
  • Fax: 301-816-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD57191
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD32986
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: