Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G-20943 | CA |
N | 207VX0000X | Obstetrician | G-20943 | CA |
NPI | 1285730275 |
---|---|
Provider Name | Dr. Gerald P Wilner |
First Address | Novato, CA 94949-8256 |
Second Address | Greenbrae, CA 94904-2009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 24/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G209430 | (05) | CA |
A41107 | (02) | CA |