Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G50781 | CA |
NPI | 1417043191 |
---|---|
Provider Name | Dr. Stephen K Gerard |
First Address | Saint Louis, MO 63126-7471 |
Second Address | Daly City, CA 94015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 12/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G507810 | (05) | CA |