Healthcare Provider Details
I. General information
NPI: 1811991847
Provider Name (Legal Business Name): MICHAEL R. GATTO MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2005
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1180 N INDIAN CANYON DR STE E311
PALM SPRINGS CA
92262-4809
US
IV. Provider business mailing address
1180 N INDIAN CANYON DR STE E311
PALM SPRINGS CA
92262-4809
US
V. Phone/Fax
- Phone: 760-323-4735
- Fax: 760-323-1167
- Phone: 760-323-4735
- Fax: 760-323-1167
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | G35026 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
MICHAEL
R
GATTO
Title or Position: PRESIDENT
Credential: MD
Phone: 760-323-4735