Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | DC14920 | CA |
Y | 213ER0200X | Radiology | DC14920 | CA |
NPI | 1093972549 |
---|---|
Provider Name | Dr. Bryan Gale Gatterman |
First Address | Castro Valley, CA 94552-4840 |
Second Address | Castro Valley, CA 94552-4840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 21/05/2008 |