Provider Demographics
NPI:1932409257
Name:BRIAN K GAW, M.D., INC.
Entity Type:Organization
Organization Name:BRIAN K GAW, M.D., INC.
Other - Org Name:BRIAN K GAW, M.D., INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KIMKYONE
Authorized Official - Last Name:GAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-951-7888
Mailing Address - Street 1:1669 W AVENUE J
Mailing Address - Street 2:SUITE 304
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2866
Mailing Address - Country:US
Mailing Address - Phone:661-951-7888
Mailing Address - Fax:661-951-8889
Practice Address - Street 1:1669 W AVENUE J
Practice Address - Street 2:SUITE 304
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2866
Practice Address - Country:US
Practice Address - Phone:661-951-7888
Practice Address - Fax:661-951-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49005208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty