Thomas J Gerke MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G59290 Issued in CA

Legal business name

THOMAS J GERKE MD INC

Practice address

4055 E Olympic Blvd
Suite 207
Los Angeles, CA 90023-3329

Phone

(323) 262-0599

Fax

(323) 262-0699

NPI assigned

Jan 18, 2007

Last updated

Sep 16, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leo Rendon

Title

Office Manager

Phone

(323) 262-0599

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1265585061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 E OLYMPIC BLVD",
            "address_2": "SUITE 207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900233329",
            "telephone_number": "323-262-0599",
            "fax_number": "323-262-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 E OLYMPIC BLVD",
            "address_2": "SUITE 207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900233329",
            "telephone_number": "323-262-0599",
            "fax_number": "323-262-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J GERKE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "RENDON",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "323-262-0599"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G59290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G592902",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.