Provider Demographics
NPI:1912007956
Name:NAT, GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:
Last Name:NAT
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 1:10800 PARAMOUNT BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3331
Mailing Address - Country:US
Mailing Address - Phone:562-904-6116
Mailing Address - Fax:562-904-4616
Practice Address - Street 1:10800 PARAMOUNT BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3331
Practice Address - Country:US
Practice Address - Phone:562-904-6116
Practice Address - Fax:562-904-4616
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG58203207N00000X
CAG058203207ND0101X, 207ND0900X, 207NI0002X, 207NP0225X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE69147Medicare UPIN
CAG58203Medicare ID - Type Unspecified