Individual
GREGG THOMAS POTTORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19842 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-4002
(510) 886-8844
(510) 247-8280
Mailing address
19842 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-4002
(510) 886-8844
(510) 247-8280
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G61064
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
G61064
CA
Other
Enumeration date
03/02/2006
Last updated
06/07/2012
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