Individual
GARY LYNN CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2522 GRAND CANAL BLVD, #1, STOCKTON, CA 95207-8213
(209) 951-4666
(209) 951-5829
Mailing address
2522 GRAND CANAL BLVD, #1, STOCKTON, CA 95207-8213
(209) 951-4666
(209) 951-5829
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C34330
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C343300
—
CA
Enumeration date
08/30/2006
Last updated
07/08/2007
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