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NPI Code Detail

MEDICARE: DR. IGA N GRAY MD, PHD

MEDICARE: DR. IGA N GRAY MD, PHD
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
1207R00000XInternal Medicine Physician57.024251OH
2207W00000XOphthalmology PhysicianA174875CA
3207W00000XOphthalmology PhysicianMD464320PA

General Provider Information

NPI Number : 1033538350
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IGA N GRAY MD, PHD
Provider Business Mailing Address
First Line : 393 E WALNUT ST
Second Line : FL 3
City : PASADENA
State : CA
Zip : 91188-0001
Country : US
Telephone Number : 800-448-6767
Fax Number : 215-339-8103
Provider Business Practice Location Address
First Line : 2610 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-5104
Country : US
Telephone Number : 800-448-6767
Fax Number : 215-339-8103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2014
Last Update Date : 02/10/2022

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