Provider Demographics
NPI:1609818004
Name:STRICH, GIDEON (MD)
Entity Type:Individual
Prefix:
First Name:GIDEON
Middle Name:
Last Name:STRICH
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 1:13762 FAIRMONT WAY
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-1845
Mailing Address - Country:US
Mailing Address - Phone:949-285-4621
Mailing Address - Fax:714-364-1803
Practice Address - Street 1:13762 FAIRMONT WAY
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-1845
Practice Address - Country:US
Practice Address - Phone:714-684-6166
Practice Address - Fax:714-364-1803
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG541672085R0202X, 208D00000X, 2085N0904X, 2085R0202X, 2085R0204X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G541670Medicaid
WG54167Medicare ID - Type Unspecified
E25291Medicare UPIN