MEDICARE: SARAH GERHART

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1780961672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH GERHART

Provider Business Mailing Address
First Line	:	3031 TISCH WAY STE 306
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 TISCH WAY STE 306
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2530
Country	:	US
Telephone Number	:	408-350-1313
Fax Number	:

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

Provider Enumeration Date	:	11/07/2011
Last Update Date	:	11/07/2011

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