Individual
DR. DAVID C GORSULOWSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
39210 STATE ST, STE 218, FREMONT, CA 94538-1456
(510) 790-0477
(510) 790-1835
Mailing address
39210 STATE ST, STE 218, FREMONT, CA 94538-1456
(510) 790-0477
(510) 790-1835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
C042190
CA
207N00000X
Dermatology Physician
Primary
C42190
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070008967
RAILROAD MEDICARE NUMBER
CA
01
—
943205645
TAX IDENTIFICATION NUMBER
CA
01
—
C42190
CALIFORNIA LICENSE NUMBER
CA
Enumeration date
06/01/2005
Last updated
03/13/2024
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