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General NPI Number Information
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NPI Number | 1386781979
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Entity Type | Individual
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Provider Name | ELLIOT GAN HONG BERNADEL-HUEY R.P.T.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 30116 EIGENBRODT WAY
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City | UNION CITY
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State | CA
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Zip | 94587-1225
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Country | US
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Telephone | 510-675-6620
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Fax | 510-675-5956
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Provider Business Mailing Address
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Address Line | 30116 EIGENBRODT WAY
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City | UNION CITY
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State | CA
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Zip | 94587-1225
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Country | US
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Telephone | 510-675-6620
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Fax | 510-675-5956
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 9341
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License Number State | CA
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