Provider Demographics
NPI:1992333835
Name:GAW, CHARLENE MELODY (MD)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:MELODY
Last Name:GAW
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 1:700 LAWRENCE EXPRESSWAY
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051
Mailing Address - Country:US
Mailing Address - Phone:408-851-4164
Mailing Address - Fax:
Practice Address - Street 1:700 LAWRENCE EXPRESSWAY
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051
Practice Address - Country:US
Practice Address - Phone:408-851-4164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA181240207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine