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NPI Code Detail

MEDICARE: STEPHANIE GAERLAN MD

MEDICARE: STEPHANIE GAERLAN MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician1770162570CA

General Provider Information

NPI Number : 1770162570
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE GAERLAN MD
Provider Business Mailing Address
First Line : 75 ROWLAND WAY STE 200
Second Line :
City : NOVATO
State : CA
Zip : 94945-5054
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 75 ROWLAND WAY STE 200
Second Line :
City : NOVATO
State : CA
Zip : 94945-5054
Country : US
Telephone Number : 415-897-3174
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2021
Last Update Date : 10/08/2024

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Directions to “ STEPHANIE GAERLAN MD” Practice Location

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