Healthcare Provider Details

I. General information

NPI: 1114084423
Provider Name (Legal Business Name): BRIAN GERY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BRIAN F GERY MD

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45280 SEELEY DR
LA QUINTA CA
92253-6834
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3202
US

V. Phone/Fax

Practice location:
  • Phone: 760-610-7300
  • Fax: 760-610-7301
Mailing address:
  • Phone: 760-610-7300
  • Fax: 760-610-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG204638
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA06178500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: