Provider Demographics
NPI:1215353685
Name:GORI, MAGGIE
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:GORI
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARGHERITA
Other - Middle Name:LALEH
Other - Last Name:GORI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA, MA
Mailing Address - Street 1:8750 MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-4500
Mailing Address - Country:US
Mailing Address - Phone:510-317-1444
Mailing Address - Fax:
Practice Address - Street 1:8750 MOUNTAIN BLVD
Practice Address - Street 2:#69
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-4500
Practice Address - Country:US
Practice Address - Phone:510-317-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2470A2800XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationAssistant Record Technician