Provider Demographics
NPI:1497015937
Name:DR. GAO MEDICAL CLINIC. INC
Entity type:Organization
Organization Name:DR. GAO MEDICAL CLINIC. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BIQI
Authorized Official - Middle Name:
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-387-3259
Mailing Address - Street 1:2485 HIGH SCHOOL AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1817
Mailing Address - Country:US
Mailing Address - Phone:925-676-1995
Mailing Address - Fax:925-676-0168
Practice Address - Street 1:2485 HIGH SCHOOL AVE STE 204
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1817
Practice Address - Country:US
Practice Address - Phone:925-676-1995
Practice Address - Fax:925-676-0168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3471455261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care