MEDICARE: DR. PATRICIA LYN GAITAN M.D.

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	208000000X	Pediatrics Physician	G54922	CA

General Provider Information

NPI Number	:	1386889632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA LYN GAITAN M.D.

Provider Business Mailing Address
First Line	:	1637 OCEAN AVE
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-6548
Country	:	US
Telephone Number	:	562-895-1313
Fax Number	:

Provider Business Practice Location Address
First Line	:	1637 OCEAN AVE
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-6548
Country	:	US
Telephone Number	:	562-895-1313
Fax Number	:

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

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	07/21/2022

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