Provider Demographics
NPI:1821255696
Name:JAY GERSHOW, M.D. , INC
Entity Type:Organization
Organization Name:JAY GERSHOW, M.D. , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-346-7223
Mailing Address - Street 1:2300 SUTTER ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3037
Mailing Address - Country:US
Mailing Address - Phone:415-346-7223
Mailing Address - Fax:415-346-1449
Practice Address - Street 1:2300 SUTTER ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3037
Practice Address - Country:US
Practice Address - Phone:415-346-7223
Practice Address - Fax:415-346-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0000G57360Medicaid
CA0000G57360Medicaid
CA000G57360Medicare PIN