Provider Demographics
NPI:1265574826
Name:GISELA C. OKONSKI, M.D., INC.
Entity type:Organization
Organization Name:GISELA C. OKONSKI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:C
Authorized Official - Last Name:OKONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-247-0404
Mailing Address - Street 1:2632 EDITH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-3031
Mailing Address - Country:US
Mailing Address - Phone:530-247-0404
Mailing Address - Fax:530-247-0472
Practice Address - Street 1:2626 EDITH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-3056
Practice Address - Country:US
Practice Address - Phone:530-247-0404
Practice Address - Fax:530-247-0472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46125207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF03944Medicare UPIN