| Steven P Gorman Md | |
|
78150 Calle Tampico Suite 100 La Quinta CA 92253-2907 | |
| (760) 564-1886 | |
| (760) 564-8558 |
| Full Name | Steven P Gorman Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 78150 Calle Tampico, La Quinta, California |
| Authorized Official Name and Position | Steven P Gorman (OWNER) |
| Authorized Official Contact | 7605647886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Steven P Gorman Md 78150 Calle Tampico Suite 100 La Quinta CA 92253-2907 Ph: (760) 564-1886 | Steven P Gorman Md 78150 Calle Tampico Suite 100 La Quinta CA 92253-2907 Ph: (760) 564-1886 |
| NPI Number | 1306117668 |
|---|---|
| Provider Enumeration Date | 01/19/2012 |
| Last Update Date | 04/14/2013 |
| Medicare PECOS PAC ID | 9830350693 |
|---|---|
| Medicare Enrollment ID | O20120423000343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306117668 | NPI | - | NPPES |
| 00G839730 | Medicaid | CA | |
| 1104926500 | Other | CA | INDV. NPI# |
| FY520Z | Other | CA | MCR PTAN IND |
| FY791A | Other | CA | MCR PTAN GRP |
| 1306117668 | Other | CA | MCR NPI GRP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G83973 (California) | Primary |
| Provider Name | Steven P Gorman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104926500 PECOS PAC ID: 8123015724 Enrollment ID: I20040427000491 |
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