Provider Demographics
NPI:1952368219
Name:C. GAIL GARDNER DOING BUSINESS AS SPECIAL NEEDS
Entity Type:Organization
Organization Name:C. GAIL GARDNER DOING BUSINESS AS SPECIAL NEEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:C
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-449-2531
Mailing Address - Street 1:17046 CASTELLO CIR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-2800
Mailing Address - Country:US
Mailing Address - Phone:858-449-2531
Mailing Address - Fax:
Practice Address - Street 1:10675 TREENA ST
Practice Address - Street 2:102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-2478
Practice Address - Country:US
Practice Address - Phone:858-578-9923
Practice Address - Fax:858-566-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME00525FOtherDMEPROVIDER