Dr. Gannon Dudlar
Emergency Physician
701 E El Camino Real
Mountain View
, California 94040-2833
Dr. Gannon Dudlar
Emergency Physician
701 E El Camino Real
Mountain View
, California 94040-2833
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About
Features
Specialties
- Emergency Physician
Languages spoken
- English
Location
First Address
- Dr. Gannon Dudlar
- 2350 W El Camino Real Fl 2
- Mountain View, CA
- Zip : 94040-6203
- Phone :
Second Address
- Dr. Gannon Dudlar
- 701 E El Camino Real
- Mountain View, CA
- Zip : 94040-2833
- Phone : (650) 934-7800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | C141676 | CA |
National Provider Identifier
| NPI | 1003865775 |
|---|---|
| Provider Name | Dr. Gannon Dudlar |
| First Address | Mountain View, CA 94040-6203 |
| Second Address | Mountain View, CA 94040-2833 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/05/2006 |
| Last Update Date | 15/01/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| H61020 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.