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Organization
IDENTITY MEDICAL GROUP, INC.
Active
Organization
IDENTITY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY M. DEUTSCH, M.D. (GENERAL PARTNER)
(805) 256-7810
Entity
Organization
Contact information
Practice address
751 E DAILY DR, SUITE 120, CAMARILLO, CA 93010-6076
(805) 256-7810
(805) 256-7840
Mailing address
751 E DAILY DR, SUITE 120, CAMARILLO, CA 93010-6076
(805) 256-7810
(805) 256-7840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
CA
Other
Enumeration date
12/17/2012
Last updated
11/18/2016
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