Organization
CS PACS 3 CA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE GIPE MD (OWNER/PRESIDENT)
(865) 693-1000
Entity
Organization
Contact information
Practice address
1949 GRANT RD, MOUNTAIN VIEW, CA 94040-3217
(650) 968-2990
Mailing address
1643 NW 136TH AVENUE, BLDG H, SUITE 100, SUNRISE, FL 33323-2857
(865) 500-1325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/24/2021
Last updated
03/06/2025
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