Individual
GARY PROFFETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
46 CALLE DEL NORTE, RANCHO MIRAGE, CA 92270-5210
(805) 658-2552
Mailing address
46 CALLE DEL NORTE, RANCHO MIRAGE, CA 92270-5210
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A31780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A317800
—
CA
Enumeration date
01/24/2007
Last updated
07/08/2007
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