Provider Demographics
NPI:1447424908
Name:GERALD L TARDER, MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GERALD L TARDER, MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:TARDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-938-6060
Mailing Address - Street 1:130 LA CASA VIA B2 107
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598
Mailing Address - Country:US
Mailing Address - Phone:925-938-6060
Mailing Address - Fax:925-938-0119
Practice Address - Street 1:130 LA CASA VIA B2 107
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-938-6060
Practice Address - Fax:925-938-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty