Provider Demographics
NPI:1568158848
Name:GERSHA APC
Entity Type:Organization
Organization Name:GERSHA APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AFROUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GERAYLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-482-2419
Mailing Address - Street 1:1240 S WESTLAKE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1975
Mailing Address - Country:US
Mailing Address - Phone:805-482-2419
Mailing Address - Fax:
Practice Address - Street 1:1240 S WESTLAKE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-1975
Practice Address - Country:US
Practice Address - Phone:805-482-2419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty