Provider Demographics
NPI:1932119146
Name:GEHL, MARSHA J (DC)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:J
Last Name:GEHL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:GEHL
Other - Middle Name:
Other - Last Name:CHIROPRACTIC, P.A.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:P.O. BOX 3273
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370
Mailing Address - Country:US
Mailing Address - Phone:208-420-8521
Mailing Address - Fax:760-452-7582
Practice Address - Street 1:2045 SAN ELIJO AVENUE
Practice Address - Street 2:
Practice Address - City:CARDIFF
Practice Address - State:CA
Practice Address - Zip Code:92007
Practice Address - Country:US
Practice Address - Phone:760-420-8335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA 589111N00000X
CA11441111N00000X
IDCHIA589111N00000X
CACA11441111N00000X
IDIDCHIA589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDTO4342Medicare UPIN
ID1672422Medicare ID - Type Unspecified