Provider Demographics
NPI:1154648285
Name:JENKINS, GERARD PIERRE (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:PIERRE
Last Name:JENKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3687 MT DIABLO BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3746
Mailing Address - Country:US
Mailing Address - Phone:916-854-6975
Mailing Address - Fax:
Practice Address - Street 1:2450 ASHBY AVE RM 5505
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2067
Practice Address - Country:US
Practice Address - Phone:510-204-4444
Practice Address - Fax:510-649-8287
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA120341207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA120341OtherSTATE LICENSE