MEDICARE: DR. GARY RONALD MONASH 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	207RG0100X	Gastroenterology Physician	13401	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1Z0218	OTHER	AZ	HEALTHNET
2	AZ0079490	OTHER	AZ	BLUE CROSS BLUE SHIELD AZ
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4094885	OTHER	AZ	AETNA

General Provider Information

NPI Number	:	1891771846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY RONALD MONASH M.D.

Provider Business Mailing Address
First Line	:	7566 N LA CHOLLA BLVD
Second Line	:	STE A
City	:	TUCSON
State	:	AZ
Zip	:	85741-2307
Country	:	US
Telephone Number	:	520-742-4139
Fax Number	:	520-742-9618

Provider Business Practice Location Address
First Line	:	7566 N LA CHOLLA BLVD
Second Line	:	STE A
City	:	TUCSON
State	:	AZ
Zip	:	85741-2307
Country	:	US
Telephone Number	:	520-742-4139
Fax Number	:	520-742-9618

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	12/18/2007

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