Provider Demographics
NPI:1306872411
Name:HOWARD, GAYLE C (MD)
Entity type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:C
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5703
Mailing Address - Country:US
Mailing Address - Phone:619-420-2111
Mailing Address - Fax:619-585-8130
Practice Address - Street 1:681 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5703
Practice Address - Country:US
Practice Address - Phone:619-420-2111
Practice Address - Fax:619-585-8130
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52755207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0067510Medicaid
CAGR0067510Medicaid
CAWC52755AMedicare PIN