Doctor Name: | DR. PAUL GORMAN |
NPI Number: | 1386853406 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A69764 |
Business Practice Address: | 570 El Camino Real Suite 260 Redwood City, CA - 940631200 |
Business Phone Number: | 6505560200 |
Business Fax Number: | 6505560201 |
Mailing Address: | 570 El Camino Real, Suite 260 REDWOOD CITY |
State: | CA |
Postal Code: | 940631200 |
Phone Number: | 6505560200 |
Fax Number: | 6505560201 |
NPI Enumeration Date: | 05/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A69764 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |