Organization
GASTRIC BANDING MEDICAL GROUP INC
Active
Other names
Ambulatory Care Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD LEROY GERTSCH M.D. (MEDICAL DIRECTOR)
(858) 715-1822
Entity
Organization
Contact information
Practice address
8705 COMPLEX DR, SAN DIEGO, CA 92123-1401
(858) 715-1822
(858) 974-7245
Mailing address
8705 COMPLEX DR, SAN DIEGO, CA 92123-1401
(858) 715-1822
(858) 974-7245
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A35980
CA
174400000X
Specialist
A67078
CA
174400000X
Specialist
Primary
C35744
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043356033
NPI
—
01
—
1124080015
NPI
—
01
—
1891877056
NPI
—
Enumeration date
07/27/2015
Last updated
07/27/2015
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