Provider Demographics
NPI:1891830881
Name:GURTNER, GEOFFREY CASH (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:CASH
Last Name:GURTNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 CAMPUS DRIVE BLDG PSRL
Mailing Address - Street 2:MC 5148 RM GK 201
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5148
Mailing Address - Country:US
Mailing Address - Phone:650-724-6672
Mailing Address - Fax:650-724-9501
Practice Address - Street 1:900 BLAKE WILBUR DR
Practice Address - Street 2:PLASTIC SURGERY CLINIC
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2201
Practice Address - Country:US
Practice Address - Phone:650-723-7002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA932832086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A9325830OtherMEDI-CAL
CAF67136Medicare ID - Type Unspecified