MEDICARE: MICHAEL R. GATTO MD, INC.

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	207Y00000X	Otolaryngology Physician	G35026	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	ZZZ05643Z	OTHER	CA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10951160	OTHER	CA	CAQH

General Provider Information

NPI Number	:	1811991847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL R. GATTO MD, INC.

Provider Business Mailing Address
First Line	:	1180 N INDIAN CANYON DR
Second Line	:	STE E311
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4809
Country	:	US
Telephone Number	:	760-323-4735
Fax Number	:	760-323-1167

Provider Business Practice Location Address
First Line	:	1180 N INDIAN CANYON DR
Second Line	:	STE E311
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4809
Country	:	US
Telephone Number	:	760-323-4735
Fax Number	:	760-323-1167

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL R GATTO
Credential	:	MD
Telephone Number	:	760-323-4735

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	04/09/2020

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