DR. BRUCE DAVID GAYNOR MD NPI 1972534253

NPI Information

NPI: 1972534253
Provider Name: DR. BRUCE DAVID GAYNOR, MD
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
4720 HOEN AVE
SANTA ROSA, CA
ZIP 95405
Phone: (707) 527-8222
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DR. Bruce David Gaynor, MD is a specialist in Santa Rosa, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Bruce David Gaynor, MD NPI is 1972534253. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4720 HOEN AVE
SANTA ROSA, CA
ZIP 95405-867
Phone: (707) 527-8222
Fax: (707) 527-5318

The enumeration date for this NPI number is 7/5/2006 and was last updated on 6/16/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207W00000X	Ophthalmology		G845350	CALIFORNIA	No
2	174400000X	Specialist		G845350	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00G845350	MEDICARE PIN	CALIFORNIA
2	3899760001	MEDICARE NSC	CALIFORNIA
3	180041368	OTHER	CALIFORNIA	MEDICARE RAILROAD
4	00G845350	MEDICAID	CALIFORNIA
5	G70889	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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