Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G74789 | CA |
Y | 208600000X | Surgeon | G74789 | CA |
N | 2086X0206X | Surgical Oncologist | G74789 | CA |
N | 208C00000X | Colorectal Surgeon | G74789 | CA |
NPI | 1124021654 |
---|---|
Provider Name | Dr. Gregory T Ginsburg |
First Address | Torrance, CA 90505-2510 |
Second Address | Torrance, CA 90505-2510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2005 |
Last Update Date | 15/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G747892 | (05) | CA |
H19460 | (02) | |
W18614 | MEDICARE (01) | CA |