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NPI Code Detail

MEDICARE: GINA M CARAVAGLIA DO

MEDICARE: GINA M CARAVAGLIA DO
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
1207QA0401XAddiction Medicine (Family Medicine) Physician2OA-8781CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538147459
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA M CARAVAGLIA DO
Provider Business Mailing Address
First Line : 74 VIA MINORCA
Second Line :
City : CATHEDRAL CITY
State : CA
Zip : 92234-1526
Country : US
Telephone Number : 760-992-3473
Fax Number : 760-797-7337
Provider Business Practice Location Address
First Line : 67580 JONES RD
Second Line :
City : CATHEDRAL CITY
State : CA
Zip : 92234-6401
Country : US
Telephone Number : 760-992-3473
Fax Number : 760-797-7337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 03/17/2018

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