MEDICARE: G2 PHYSICIANS LLC

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1679113849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	G2 PHYSICIANS LLC

Provider Business Mailing Address
First Line	:	20280 N 59TH AVE STE 115-528
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-6850
Country	:	US
Telephone Number	:	310-722-9167
Fax Number	:

Provider Business Practice Location Address
First Line	:	20280 N 59TH AVE STE 115-528
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-6850
Country	:	US
Telephone Number	:	310-722-9167
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	GEORGE GENDY
Credential	:	MD
Telephone Number	:	310-722-9167

Provider Enumeration Date	:	01/15/2020
Last Update Date	:	05/05/2020

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