Provider Demographics
NPI:1023154234
Name:SEARLS, GWYNNE L (PA)
Entity type:Individual
Prefix:MS
First Name:GWYNNE
Middle Name:L
Last Name:SEARLS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:DEPT 34929
Mailing Address - Street 2:P.O. BOX 39000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-0001
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:925-952-2850
Practice Address - Street 1:140 BROOKWOOD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-3042
Practice Address - Country:US
Practice Address - Phone:925-254-9090
Practice Address - Fax:925-254-4399
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2012-06-21
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Provider Licenses
StateLicense IDTaxonomies
CAPA10704363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical