Provider Demographics
NPI:1841380524
Name:GELMAN, BORIS (MD)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:GELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3711 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 905
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3315
Mailing Address - Country:US
Mailing Address - Phone:310-469-5111
Mailing Address - Fax:310-469-5201
Practice Address - Street 1:3711 LONG BEACH BLVD
Practice Address - Street 2:SUITE 905
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3315
Practice Address - Country:US
Practice Address - Phone:310-469-5111
Practice Address - Fax:310-469-5201
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95740207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2759386Medicaid
OH000000225726OtherUNISON
OH750602OtherBUCKEYE MEDICAID
OH414654OtherWELLCARE MEDICAID
OHGE4210351Medicare PIN
OH9626056OtherAETNA
OH000000527723OtherANTHEM
OH0583328OtherBCMH