Individual
GEROME MEDINACELI GEPIGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(800) 826-4673
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
67602
CA
363AS0400X
Surgical Physician Assistant
1145
NH
363AS0400X
Surgical Physician Assistant
61032719
WA
363AS0400X
Surgical Physician Assistant
6763
CT
Other
Enumeration date
02/05/2016
Last updated
03/24/2026
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