Provider Demographics
NPI:1679922892
Name:GYSI, MADELEINE (MD)
Entity type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:
Last Name:GYSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 INDIAN HILLS RD STE 371
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1252
Mailing Address - Country:US
Mailing Address - Phone:818-365-1194
Mailing Address - Fax:818-898-3835
Practice Address - Street 1:11550 INDIAN HILLS RD STE 371
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1252
Practice Address - Country:US
Practice Address - Phone:818-365-1194
Practice Address - Fax:818-898-3835
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA161123207RN0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty