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General NPI Number Information
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NPI Number | 1982020269
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Entity Type | Organization
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Legal Business Name | CAROL A. GERDES M.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 05/09/2014
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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 | 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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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CAROL A GERDES
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Credential | M.D.
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Telephone | 510-864-0660
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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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