Provider Demographics
NPI:1962461046
Name:GELMAN, JULIE A (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:GELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 NIPOMO ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6155
Mailing Address - Country:US
Mailing Address - Phone:805-439-2998
Mailing Address - Fax:805-439-2997
Practice Address - Street 1:1023 NIPOMO ST STE 110
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-439-2998
Practice Address - Fax:805-439-2997
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69995207R00000X
CAG144586208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110132979OtherRAIL ROAD MEDICARE
FL250216000Medicaid
FL250216000Medicaid
110132979OtherRAIL ROAD MEDICARE