Provider Demographics
NPI:1992037253
Name:FLAIG, GERALYN ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALYN
Middle Name:ANN
Last Name:FLAIG
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:PO BOX 4586
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95604-4586
Mailing Address - Country:US
Mailing Address - Phone:530-886-8753
Mailing Address - Fax:
Practice Address - Street 1:355 RACETRACK ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5423
Practice Address - Country:US
Practice Address - Phone:916-718-7482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG036814207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE90555Medicare UPIN