1033389572 NPI number — STEVEN L. GINEX, DPM INC

Table of content: (NPI 1033389572)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033389572 NPI number — STEVEN L. GINEX, DPM INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEVEN L. GINEX, DPM INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033389572
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
74050 ALESSANDRO DR
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
PALM DESERT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92260-3705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-340-3232
Provider Business Mailing Address Fax Number:
760-776-1424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
74050 ALESSANDRO DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
PALM DESERT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92260-3705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-340-3232
Provider Business Practice Location Address Fax Number:
760-776-1424
Provider Enumeration Date:
03/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GINEX
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
LOUIS
Authorized Official Title or Position:
CEO/ DOCTOR
Authorized Official Telephone Number:
760-340-3232

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000E38930 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00817023 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: DQ1338 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".




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