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Organization
STEVEN P GORMAN MD INC.
Active
Organization
STEVEN P GORMAN MD INC.
Active
Other names
STEVEN P GORMAN MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN P GORMAN MD (OWNER)
(760) 564-7886
Entity
Organization
Contact information
Practice address
78150 CALLE TAMPICO, SUITE 100, LA QUINTA, CA 92253-2907
(760) 564-1886
(760) 564-8558
Mailing address
78150 CALLE TAMPICO, SUITE 100, LA QUINTA, CA 92253-2907
(760) 564-1886
(760) 564-8558
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G83973
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G839730
—
CA
01
—
1104926500
INDV. NPI#
CA
01
—
1306117668
MCR NPI GRP
CA
01
—
FY520Z
MCR PTAN IND
CA
01
—
FY791A
MCR PTAN GRP
CA
Enumeration date
01/19/2012
Last updated
04/14/2013
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