Healthcare Provider Details

I. General information

NPI: 1164522983
Provider Name (Legal Business Name): JAMES B FLOREY MD & EUGENIA P GARY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 MORAGA RD SUITE 3
LAFAYETTE CA
94549-4593
US

IV. Provider business mailing address

3413 STAGE COACH DR
LAFAYETTE CA
94549-1817
US

V. Phone/Fax

Practice location:
  • Phone: 925-283-8336
  • Fax: 925-283-1877
Mailing address:
  • Phone: 925-297-4191
  • Fax: 510-268-1227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberC36748
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES BRUCE FLOREY
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 925-297-4191