# GERARD BAZILE MD A PROFESSIONAL MEDICAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952316812
- **Authorized official:** DR. GERARD IRVELT BAZILE MD (OWNER)
- **Authorized official phone:** (619) 286-0100

## Contact information

- **Practice address:** 6699 ALVARADO RD, SUITE 2306, SAN DIEGO, CA 92120-5238
- **Practice address phone:** (619) 286-0100
- **Practice address fax:** (619) 286-0600
- **Mailing address:** PO BOX 1770, LA MESA, CA 91944-1770
- **Mailing address phone:** (619) 464-1165
- **Mailing address fax:** (619) 567-1011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 07/11/2014