MEDICARE: RODNEY D GIN 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
1	207Q00000X	Family Medicine Physician	A64749	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NONE	OTHER	CA	NONE

General Provider Information

NPI Number	:	1851584015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY D GIN M.D.

Provider Business Mailing Address
First Line	:	15055 LOS GATOS BLVD STE 100
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2056
Country	:	US
Telephone Number	:	408-356-1000
Fax Number	:	408-356-1125

Provider Business Practice Location Address
First Line	:	15055 LOS GATOS BLVD STE 100
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2056
Country	:	US
Telephone Number	:	408-356-1000
Fax Number	:	408-356-1125

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

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	08/21/2007

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Directions to “ RODNEY D GIN M.D.” Practice Location

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