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General NPI Number Information
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NPI Number | 1952534422
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Entity Type | Individual
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Provider Name | GAUTHAM S IYER NP
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Gender | Male
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 500 PARNASSUS AVE 4TH FLOOR MUW-420A
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City | SAN FRANCISCO
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State | CA
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Zip | 94143
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Country | US
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Telephone | 573-999-5365
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Fax |
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Provider Business Mailing Address
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Address Line | 500 PARNASSUS AVE 4TH FLOOR MUW-420A
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2203
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Country | US
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Telephone | 573-999-5365
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2009022049
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 18360
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License Number State | CA
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