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NPI Code Detail

MEDICARE: DR. ANDREW PAUL GERKEN M.D.

MEDICARE: DR. ANDREW PAUL GERKEN 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
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianG73203CA
2207XX0004XOrthopaedic Foot and Ankle Surgery PhysicianG73203CA

General Provider Information

NPI Number : 1538105739
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW PAUL GERKEN M.D.
Provider Business Mailing Address
First Line : 22 CORPORATE PLAZA DR
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-7901
Country : US
Telephone Number : 949-722-7038
Fax Number :
Provider Business Practice Location Address
First Line : 22 CORPORATE PLAZA DR
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-7901
Country : US
Telephone Number : 949-722-7038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 02/17/2020

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