Organization
WALLACE G GOSNEY MD & GILBERT R TURNER MD PTRS
Active
Other names
Upland Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN SPIVACK MD (PARTNER)
(909) 946-5320
Entity
Organization
Contact information
Practice address
510 N 13TH AVE STE 204, UPLAND, CA 91786-4965
(909) 920-0525
(909) 920-0526
Mailing address
510 N 13TH AVE STE 204, UPLAND, CA 91786-4965
(909) 920-0525
(909) 920-0526
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A65402
CA
208600000X
Surgery Physician
Primary
G67360
CA
2086S0129X
Vascular Surgery Physician
A65402
CA
2086X0206X
Surgical Oncology Physician
G67360
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071670
—
CA
Enumeration date
07/13/2006
Last updated
06/20/2019
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