MEDICARE: BRUCE M. GACH, M.D., 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	174400000X	Specialist	G21896	CA

General Provider Information

NPI Number	:	1801897806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUCE M. GACH, M.D., INC.

Provider Business Mailing Address
First Line	:	1133 E STANLEY BLVD
Second Line	:	#103
City	:	LIVERMORE
State	:	CA
Zip	:	94550-4200
Country	:	US
Telephone Number	:	925-455-5050
Fax Number	:	925-455-6560

Provider Business Practice Location Address
First Line	:	1133 E STANLEY BLVD
Second Line	:	#103
City	:	LIVERMORE
State	:	CA
Zip	:	94550-4200
Country	:	US
Telephone Number	:	925-455-5050
Fax Number	:	925-455-6560

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRUCE M GACH
Credential	:	M.D.
Telephone Number	:	925-455-5050

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	03/07/2013

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