Provider Demographics
NPI:1982639571
Name:FRANK, GERARD WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:WILLIAM
Last Name:FRANK
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 1:1223 16TH ST
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1217
Mailing Address - Country:US
Mailing Address - Phone:310-449-0939
Mailing Address - Fax:310-449-7790
Practice Address - Street 1:1223 16TH ST
Practice Address - Street 2:SUITE 3400
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1217
Practice Address - Country:US
Practice Address - Phone:310-449-0939
Practice Address - Fax:310-449-7790
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG37261207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G372610Medicaid
CAWG37261DMedicare PIN
CAA91875Medicare UPIN