Provider Demographics
NPI:1386707131
Name:KARDONG, GLORIA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:MARIE
Last Name:KARDONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:969 G EDGEWATER BLVD
Mailing Address - Street 2:#385
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404
Mailing Address - Country:US
Mailing Address - Phone:650-329-9465
Mailing Address - Fax:650-329-9869
Practice Address - Street 1:690 WAVERLEY STREET
Practice Address - Street 2:
Practice Address - City:PALE ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301
Practice Address - Country:US
Practice Address - Phone:650-329-9465
Practice Address - Fax:650-329-9869
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG0608052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry