Provider Demographics
NPI:1104907138
Name:GATES, DON F III (LAC)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:F
Last Name:GATES
Suffix:III
Gender:M
Credentials:LAC
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Mailing Address - Street 1:58 RAMONA AVE
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4245
Mailing Address - Country:US
Mailing Address - Phone:510-658-2282
Mailing Address - Fax:510-654-7054
Practice Address - Street 1:330 41ST ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2653
Practice Address - Country:US
Practice Address - Phone:510-428-9430
Practice Address - Fax:510-654-7054
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC 8908171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist