1366608093 NPI number — CHRISTINE MARIE GEBERT-PARIKH MD

Table of content: CHRISTINE MARIE GEBERT-PARIKH MD (NPI 1366608093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366608093 NPI number — CHRISTINE MARIE GEBERT-PARIKH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEBERT-PARIKH
Provider First Name:
CHRISTINE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GEBERT
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1366608093
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 WILLOW RD
Provider Second Line Business Mailing Address:
BUILDING 17
Provider Business Mailing Address City Name:
MENLO PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94025-1452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-521-5449
Provider Business Mailing Address Fax Number:
650-521-5444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 WILLOW RD
Provider Second Line Business Practice Location Address:
BUILDING 17
Provider Business Practice Location Address City Name:
MENLO PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94025-1452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-521-5449
Provider Business Practice Location Address Fax Number:
650-521-5444
Provider Enumeration Date:
08/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A102038 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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