Provider Demographics
NPI:1982676276
Name:GELRUD, ADAM K (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:K
Last Name:GELRUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12900 PARK PLAZA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9329
Mailing Address - Country:US
Mailing Address - Phone:562-977-4639
Mailing Address - Fax:562-741-7749
Practice Address - Street 1:5620 BROOK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-2273
Practice Address - Country:US
Practice Address - Phone:804-767-8400
Practice Address - Fax:804-262-5113
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101234989207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00145319OtherRAILROAD MEDICARE
VA010078369Medicaid
VA010236703Medicaid
VA188196OtherBCBS
VA139730OtherBCBS
VA004757P92Medicare PIN
VA00W953P05Medicare PIN
VA139730OtherBCBS
VAI08745Medicare UPIN