Individual
MITCHELL ALLEN GEVELBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 S BASCOM AVE, PEDIATRICS DEPARTMENT, SAN JOSE, CA 95128-2604
(408) 885-5445
Mailing address
1027 DAISY CT, SUNNYVALE, CA 94086-8254
(408) 246-2557
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A70083
CA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
A70083
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A700830
—
CA
Enumeration date
04/10/2006
Last updated
10/05/2012
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