Individual
DR. KERRY NORMAN GOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
255 E BONITA AVE, POMONA, CA 91767-1923
(909) 596-7733
(909) 450-0357
Mailing address
PO BOX 9389, ALTA LOMA, CA 91701-8389
(909) 268-5645
(909) 450-0357
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
G65566
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C655660
—
CA
01
—
BK903Z
MEDICARE NO CAL PTAN
—
01
—
G65566
CA LICENSE #
CA
05
—
GR0059670
—
CA
Enumeration date
06/02/2006
Last updated
03/07/2023
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