Provider Demographics
NPI:1306901087
Name:GERRO, MARSHA ANNE HATEM (MD)
Entity type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:ANNE HATEM
Last Name:GERRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARSHA
Other - Middle Name:ANNE
Other - Last Name:HATEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:303 S GLENOAKS BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1319
Mailing Address - Country:US
Mailing Address - Phone:818-842-5555
Mailing Address - Fax:818-842-0355
Practice Address - Street 1:303 S GLENOAKS BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1319
Practice Address - Country:US
Practice Address - Phone:818-842-5555
Practice Address - Fax:818-842-0355
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43078208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics