Individual provider · Type 1 NPI
Gaye Derusso, P.A.
Surgical Physician Assistant · Berkeley, CA
NPI number
1184658783
Active
Practice location
2999 Regent St, Ste 225
Berkeley, CA 94705-2190
Fax (510) 704-7765
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | PA15294 (CA) |
Surgical Physician Assistant: Definition to come...
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About NPI 1184658783
Gaye Derusso, P.A.'s National Provider Identifier is 1184658783, issued on Jul 10, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Berkeley, CA. The record was last updated on Feb 26, 2013.