Provider Demographics
NPI:1568523892
Name:KERLIN, DEBORAH LYNN (MD, FACS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:KERLIN
Suffix:
Gender:F
Credentials:MD, FACS
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:365 LENNON LN
Mailing Address - Street 2:SUITE 350
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5910
Mailing Address - Country:US
Mailing Address - Phone:925-932-6330
Mailing Address - Fax:925-932-0139
Practice Address - Street 1:112 LA CASA VIA
Practice Address - Street 2:SUITE 340
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3091
Practice Address - Country:US
Practice Address - Phone:925-945-7600
Practice Address - Fax:925-945-7664
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG54324208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE25203Medicare UPIN
CA00G543241Medicare ID - Type UnspecifiedPPIN