MEDICARE: LORIE GEARHART MD INC

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	2084F0202X	Forensic Psychiatry Physician

General Provider Information

NPI Number	:	1568869568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LORIE GEARHART MD INC

Provider Business Mailing Address
First Line	:	820 BAY AVE STE 206
Second Line	:
City	:	CAPITOLA
State	:	CA
Zip	:	95010-2102
Country	:	US
Telephone Number	:	831-246-6392
Fax Number	:	831-600-7528

Provider Business Practice Location Address
First Line	:	820 BAY AVE STE 206
Second Line	:
City	:	CAPITOLA
State	:	CA
Zip	:	95010-2102
Country	:	US
Telephone Number	:	831-427-3100
Fax Number	:	831-515-7037

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	LORIE GEARHART
Credential	:	MD
Telephone Number	:	831-246-6392

Provider Enumeration Date	:	11/20/2014
Last Update Date	:	05/15/2026

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