Individual
KEVIN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1411 E 31ST ST, OAKLAND, CA 94602-1018
(510) 437-8356
Mailing address
1411 E 31ST ST, OAKLAND, CA 94602-1092
(510) 437-4800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
147618
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
70723
CT
Other
Enumeration date
04/08/2015
Last updated
06/18/2024
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