Provider Demographics
NPI:1518926559
Name:OKONSKI, GISELA C (MD)
Entity Type:Individual
Prefix:MS
First Name:GISELA
Middle Name:C
Last Name:OKONSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2632 EDITH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-3031
Mailing Address - Country:US
Mailing Address - Phone:530-247-0404
Mailing Address - Fax:530-247-0472
Practice Address - Street 1:2632 EDITH AVENUE, STE C
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-9600
Practice Address - Country:US
Practice Address - Phone:530-247-0404
Practice Address - Fax:530-247-0472
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46125207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A461253Medicare PIN
CAF03944Medicare UPIN