Provider Demographics
NPI:1407071087
Name:PONSONES, GIL RESURRECCION (CNP)
Entity Type:Individual
Prefix:MR
First Name:GIL
Middle Name:RESURRECCION
Last Name:PONSONES
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:505 PARNASSUS AVENUE
Mailing Address - Street 2:ROOM M-917
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0624
Mailing Address - Country:US
Mailing Address - Phone:415-353-1847
Mailing Address - Fax:415-353-1990
Practice Address - Street 1:505 PARNASSUS AVENUE
Practice Address - Street 2:ROOM M-917
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0624
Practice Address - Country:US
Practice Address - Phone:415-353-1847
Practice Address - Fax:415-353-1990
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704203777363L00000X
CA18989363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner