Provider Demographics
NPI:1538347455
Name:GOTTS, JEFFREY EARL (MD/PHD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:EARL
Last Name:GOTTS
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 PARNASSUS AVE
Mailing Address - Street 2:BOX 0131
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2208
Mailing Address - Country:US
Mailing Address - Phone:415-353-2131
Mailing Address - Fax:415-353-2489
Practice Address - Street 1:533 PARNASSUS AVE
Practice Address - Street 2:BOX 0131
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2208
Practice Address - Country:US
Practice Address - Phone:415-353-2131
Practice Address - Fax:415-353-2489
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine