| Thomas J Gerke Md Inc | |
|
4055 E Olympic Blvd Suite 207 Los Angeles CA 90023-3329 | |
| (323) 262-0599 | |
| (323) 262-0699 |
| Full Name | Thomas J Gerke Md Inc |
|---|---|
| Speciality | General Practice |
| Location | 4055 E Olympic Blvd, Los Angeles, California |
| Authorized Official Name and Position | Leo Rendon (OFFICE MANAGER) |
| Authorized Official Contact | 3232620599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas J Gerke Md Inc 4055 E Olympic Blvd Suite 207 Los Angeles CA 90023-3329 Ph: (323) 262-0599 | Thomas J Gerke Md Inc 4055 E Olympic Blvd Suite 207 Los Angeles CA 90023-3329 Ph: (323) 262-0599 |
| NPI Number | 1265585061 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 09/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265585061 | NPI | - | NPPES |
| 00G592902 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | G59290 (California) | Primary |
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