Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | G19754 | CA |
Y | 207RP1001X | Pulmonary Disease | G19754 | CA |
NPI | 1013950575 |
---|---|
Provider Name | Gerald L. Meyers |
First Address | Berkeley, CA 94705-2049 |
Second Address | Berkeley, CA 94705-2067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 10/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G197540 | (05) | CA |
A40743 | (02) |