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General NPI Number Information
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NPI Number | 1033673173
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Entity Type | Organization
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Legal Business Name | GAYLE CEKADA MD INC A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 184 CASA ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-1804
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Country | US
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Telephone | 805-903-1391
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Fax | 805-785-0367
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Provider Business Mailing Address
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Address Line | 184 CASA ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-1804
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Country | US
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Telephone | 805-903-1391
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Fax | 805-785-0367
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Authorized Official
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Title or Position | PRESIDENT
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Name | GAYLE S. CEKADA
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Credential | MD
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Telephone | 805-903-1391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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