Provider Demographics
NPI:1598740953
Name:PAPILLION, GERLIE L (MD)
Entity Type:Individual
Prefix:
First Name:GERLIE
Middle Name:L
Last Name:PAPILLION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W 6TH ST
Mailing Address - Street 2:# P
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-6014
Mailing Address - Country:US
Mailing Address - Phone:408-848-2170
Mailing Address - Fax:408-848-4244
Practice Address - Street 1:700 W 6TH ST
Practice Address - Street 2:# P
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-6014
Practice Address - Country:US
Practice Address - Phone:408-848-2170
Practice Address - Fax:408-848-4244
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40095207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C400950Medicaid
A37302Medicare UPIN
00C400950Medicare ID - Type Unspecified