Super, George Gregory

Super, George Gregory is an individual health care provider with primary practice located at One Hoag Dr Ecu Dept, Newport Beach CA 92663-4162. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Super, George Gregory can be contacted via phone (949) 764-5689.

Contact Information

Primary practice address
One Hoag Dr Ecu Dept Newport Beach CA 92663-4162
Phone: (949) 764-5689
Fax: (405) 751-3183
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X C32629 California

Profile Details

NPI number 1790748507
LBN Legal business name Super, George Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2006
Last updated Sep 20th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790748507 NPPES
California MEDICAID 00C326290670
California Other P00242844
California Other 00C326290
California MEDICAID 00C326290

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