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General NPI Number Information
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NPI Number | 1154356301
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Entity Type | Organization
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Legal Business Name | GARY LYNN MD MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 777 KNOWLES DR #15
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City | LOS GATOS
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State | CA
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Zip | 95032
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Country | US
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Telephone | 408-358-7460
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Fax | 408-384-5489
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Provider Business Mailing Address
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Address Line | 777 KNOWLES DR #15
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City | LOS GATOS
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State | CA
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Zip | 95032-1417
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Country | US
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Telephone | 408-358-7460
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Fax | 408-384-5489
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARY LYNN
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Credential | MD
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Telephone | 408-358-7460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A60126
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License Number State | CA
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