Basic Information
| Provider Information | |||||||||
| NPI: | 1780694802 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GER | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | SERENE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10790 RANCHO BERNARDO RD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921275705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585547439 | ||||||||
| FaxNumber: | 7606344845 | ||||||||
| Practice Location | |||||||||
| Address1: | 2176 SALK AVE | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920087346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585547439 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 04/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A71865 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 2083X0100X | A71865 | CA | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | 207Q00000X | A71865 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00A718650 | 05 | CA | MEDICAID |