MEDICARE: GREGG GARNER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	20A6253	CA

General Provider Information

NPI Number	:	1023006418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGG GARNER D.O.

Provider Business Mailing Address
First Line	:	1684 TORRANCE ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-3746
Country	:	US
Telephone Number	:	858-499-4421
Fax Number	:	858-636-2001

Provider Business Practice Location Address
First Line	:	1684 TORRANCE ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-3746
Country	:	US
Telephone Number	:	858-499-4421
Fax Number	:	858-636-2001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	08/11/2009

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