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NPI Code Detail

MEDICARE: DR. JOSHUA LAYNE GARY MD

MEDICARE: DR. JOSHUA LAYNE GARY MD
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
1207XX0801XOrthopaedic Trauma PhysicianM7987TX
2207XX0801XOrthopaedic Trauma PhysicianC171591CA

General Provider Information

NPI Number : 1063624658
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA LAYNE GARY MD
Provider Business Mailing Address
First Line : PO BOX 31309
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-0309
Country : US
Telephone Number : 323-442-5860
Fax Number :
Provider Business Practice Location Address
First Line : 1520 SAN PABLO ST STE 2000
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-5322
Country : US
Telephone Number : 323-442-5860
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 12/08/2021

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