Provider Demographics
NPI:1710083159
Name:GAIO HANSBERGER, KAREN LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNN
Last Name:GAIO HANSBERGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:25455 BARTON ROAD
Mailing Address - Street 2:SUITE A208
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354
Mailing Address - Country:US
Mailing Address - Phone:909-799-7900
Mailing Address - Fax:909-796-0334
Practice Address - Street 1:25455 BARTON ROAD
Practice Address - Street 2:SUITE A208
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354
Practice Address - Country:US
Practice Address - Phone:909-799-7900
Practice Address - Fax:909-796-0334
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG74945207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG06130Medicare UPIN
00G749450Medicare ID - Type Unspecified