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General NPI Number Information
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NPI Number | 1417063306
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Entity Type | Individual
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Provider Name | CAROL A GERDES MD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 501 S SHORE CTR W SUITE D
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City | ALAMEDA
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State | CA
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Zip | 94501-5762
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Country | US
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Telephone | 510-864-0660
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Fax | 510-864-0393
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Provider Business Mailing Address
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Address Line | PO BOX 211414
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City | CHULA VISTA
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State | CA
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Zip | 91921-1414
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Country | US
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Telephone | 619-600-4230
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Fax | 866-633-4209
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G62236
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License Number State | CA
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