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General NPI Number Information
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NPI Number | 1033008222
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Entity Type | Individual
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Provider Name | GURDAS MANN OD
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Gender | Male
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2474 SE BURNSIDE RD
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City | GRESHAM
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State | OR
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Zip | 97080-1247
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Country | US
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Telephone | 503-489-5771
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Fax | 503-489-5778
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Provider Business Mailing Address
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Address Line | 2474 SE BURNSIDE RD
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City | GRESHAM
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State | OR
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Zip | 97080-1247
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Country | US
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Telephone | 503-489-5771
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Fax | 503-489-5778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | AT4772
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License Number State | OR
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