Provider Demographics
NPI:1598874422
Name:BELCHER, GREGORY L (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:L
Last Name:BELCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18805 COX AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-6616
Mailing Address - Country:US
Mailing Address - Phone:408-379-8141
Mailing Address - Fax:408-379-8196
Practice Address - Street 1:18805 COX AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-6616
Practice Address - Country:US
Practice Address - Phone:408-379-8141
Practice Address - Fax:408-379-8196
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG66631207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF11187Medicare UPIN
CA00G66310Medicare ID - Type Unspecified