Provider Demographics
NPI:1952436750
Name:BEJARANO, GIL (ATC)
Entity type:Individual
Prefix:MR
First Name:GIL
Middle Name:
Last Name:BEJARANO
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10108 SHEFFIELD OAK WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1341
Mailing Address - Country:US
Mailing Address - Phone:916-685-1123
Mailing Address - Fax:
Practice Address - Street 1:4700 COLLEGE OAK DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4217
Practice Address - Country:US
Practice Address - Phone:916-484-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer