Gorsulowsky, David C

Gorsulowsky, David C is an individual health care provider with primary practice located at 39210 State St Ste 218, Fremont CA 94538-1456. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Gorsulowsky, David C can be contacted via phone (510) 790-0477.

Contact Information

Primary practice address
39210 State St Ste 218 Fremont CA 94538-1456
Phone: (510) 790-0477
Fax: (510) 790-1835
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X C042190 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X C42190 California

Profile Details

NPI number 1649272832
LBN Legal business name Gorsulowsky, David C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Mar 13th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649272832 NPPES
California Other 943205645 TAX IDENTIFICATION NUMBER
California Other C42190 TAX IDENTIFICATION NUMBER
California Other 070008967 TAX IDENTIFICATION NUMBER

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