MEDICARE: DR. GREGORY T GINSBURG M.D.

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	163WW0000X	Wound Care Registered Nurse	G74789	CA
2	2086X0206X	Surgical Oncology Physician	G74789	CA
3	208C00000X	Colon & Rectal Surgery Physician	G74789	CA
4	208600000X	Surgery Physician	G74789	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W18614	OTHER	CA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124021654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY T GINSBURG M.D.

Provider Business Mailing Address
First Line	:	3531 FASHION WAY STE 3
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-3809
Country	:	US
Telephone Number	:	310-372-4500
Fax Number	:	310-372-4505

Provider Business Practice Location Address
First Line	:	3531 FASHION WAY STE 3
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-3809
Country	:	US
Telephone Number	:	310-372-4500
Fax Number	:	310-372-4505

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	01/26/2023

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