Provider Demographics
NPI:1154178226
Name:DAVID A GEHRET MD- A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:DAVID A GEHRET MD- A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GEHRET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-873-6610
Mailing Address - Street 1:6499 S KINGS RANCH RD STE 6
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-2920
Mailing Address - Country:US
Mailing Address - Phone:949-873-6610
Mailing Address - Fax:
Practice Address - Street 1:366 SAN MIGUEL DR STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7810
Practice Address - Country:US
Practice Address - Phone:949-873-6610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty