MEDICARE: DR. STUART JAY MENN 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	174400000X	Specialist	G17625	CA
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	G17625	CA

General Provider Information

NPI Number	:	1497775746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART JAY MENN M.D.

Provider Business Mailing Address
First Line	:	1180 N INDIAN CANYON DR STE W304
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4809
Country	:	US
Telephone Number	:	760-325-4100
Fax Number	:	760-778-6785

Provider Business Practice Location Address
First Line	:	1180 N INDIAN CANYON DR STE W304
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4809
Country	:	US
Telephone Number	:	760-325-4100
Fax Number	:	760-778-6785

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	10/10/2023

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Directions to “ DR. STUART JAY MENN M.D.” Practice Location

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