MEDICARE: DR. SHARON LYNN GORMAN PT, DPTSC, GCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251G0304X	Geriatric Physical Therapist	18757	CA

General Provider Information

NPI Number	:	1366656217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON LYNN GORMAN PT, DPTSC, GCS

Provider Business Mailing Address
First Line	:	450 30TH ST
Second Line	:	SUITE 3734
City	:	OAKLAND
State	:	CA
Zip	:	94609-3302
Country	:	US
Telephone Number	:	510-869-6511
Fax Number	:	510-869-6282

Provider Business Practice Location Address
First Line	:	450 30TH ST
Second Line	:	SUITE 3734
City	:	OAKLAND
State	:	CA
Zip	:	94609-3302
Country	:	US
Telephone Number	:	510-869-6511
Fax Number	:	510-869-6282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	01/03/2022

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