Provider Demographics
NPI:1558620377
Name:GLADYS E. NEGRON, M.D. INC.
Entity Type:Organization
Organization Name:GLADYS E. NEGRON, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-382-5230
Mailing Address - Street 1:1687 ERRINGER RD
Mailing Address - Street 2:102
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-6508
Mailing Address - Country:US
Mailing Address - Phone:805-526-9110
Mailing Address - Fax:
Practice Address - Street 1:1687 ERRINGER RD
Practice Address - Street 2:102
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-6508
Practice Address - Country:US
Practice Address - Phone:805-526-9110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65789207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty