Provider Demographics
NPI:1902950660
Name:GEAN, GEOFFREY J (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:J
Last Name:GEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2316
Mailing Address - Country:US
Mailing Address - Phone:818-502-2050
Mailing Address - Fax:818-241-3575
Practice Address - Street 1:600 S GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2316
Practice Address - Country:US
Practice Address - Phone:818-502-2050
Practice Address - Fax:818-241-3575
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG272482083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine