Individual
NICHOLAS GAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(212) 241-6500
Mailing address
1761 E 38TH ST, OAKLAND, CA 94602-1655
(732) 887-9603
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
269056
NY
207P00000X
Emergency Medicine Physician
A114742
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A114742
CALIFORNIA MEDICAL BOARD, MEDICAL LICENSE NUMBER
CA
Enumeration date
11/02/2010
Last updated
07/01/2025
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