Provider Demographics
NPI:1285730275
Name:WILNER, GERALD P (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:P
Last Name:WILNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 HAMILTON LNDG
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-8256
Mailing Address - Country:US
Mailing Address - Phone:415-884-1840
Mailing Address - Fax:415-883-7127
Practice Address - Street 1:1260 S ELISEO DR
Practice Address - Street 2:FLOOR 2
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2009
Practice Address - Country:US
Practice Address - Phone:415-461-7800
Practice Address - Fax:415-461-8619
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2014-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG-20943207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G209430Medicaid
CAA41107Medicare UPIN
CA00G209430Medicaid