Organization
GASTROINTESTINAL ASSOC A MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN M CLEARY MD (OWNER)
(760) 325-7601
Entity
Organization
Contact information
Practice address
555 E TACHEVAH DR, SUITE #1E-104, PALM SPRINGS, CA 92262-5750
(760) 325-7601
(760) 325-4281
Mailing address
555 E TACHEVAH DR, #1E-104, PALM SPRINGS, CA 92262-5750
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ89111Z
BLUE SHIELD
CA
Enumeration date
10/03/2006
Last updated
01/15/2008
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