Provider Demographics
NPI:1831499607
Name:GAYLE R MISLE MD PC
Entity Type:Organization
Organization Name:GAYLE R MISLE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MISLE MD PC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-885-0225
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:
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:510-885-0225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38840207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty