Individual
DWIGHT DAVID GAGGERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3460 GLENDORA DR, SAN MATEO, CA 94403-3943
(650) 759-2687
(650) 572-9654
Mailing address
3460 GLENDORA DR, SAN MATEO, CA 94403-3943
(650) 759-2687
(650) 572-9654
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G58937
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G589370
BLUE SHIELD
CA
05
—
00G589370
—
CA
Enumeration date
11/02/2005
Last updated
12/27/2022
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