Provider Demographics
NPI:1053597138
Name:DAUM, GARRETT CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:CHRISTOPHER
Last Name:DAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25338 BUCKEYE DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-5462
Mailing Address - Country:US
Mailing Address - Phone:510-259-8227
Mailing Address - Fax:
Practice Address - Street 1:20980 REDWOOD RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5930
Practice Address - Country:US
Practice Address - Phone:510-390-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG556162084P0800X
WAMD000407572084P0800X, 2084P0805X
CAG656162084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry