Provider Demographics
NPI:1609846401
Name:MISLE, GAYLE RUTH (MD)
Entity Type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:RUTH
Last Name:MISLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2186
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-0186
Mailing Address - Country:US
Mailing Address - Phone:510-885-0225
Mailing Address - Fax:510-885-0226
Practice Address - Street 1:15035 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1901
Practice Address - Country:US
Practice Address - Phone:510-276-2800
Practice Address - Fax:510-276-2896
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG38840207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1609846401OtherNPI
CADT775BOtherPTAN
CADT785ZOtherPTAN
G38840OtherLICENSE NUMBER
CA1831499607OtherNPI
CA1831499607OtherNPI