Provider Demographics
NPI:1760855399
Name:GEISS MED DURABLE MEDICAL EQUIPMENT D.O. MEDICAL CORPORATION
Entity type:Organization
Organization Name:GEISS MED DURABLE MEDICAL EQUIPMENT D.O. MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:GEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-223-5920
Mailing Address - Street 1:1050 E YORBA LINDA BLVD
Mailing Address - Street 2:STE.104
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3730
Mailing Address - Country:US
Mailing Address - Phone:714-223-5920
Mailing Address - Fax:866-550-4794
Practice Address - Street 1:1050 E YORBA LINDA BLVD
Practice Address - Street 2:STE.104
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3730
Practice Address - Country:US
Practice Address - Phone:714-223-5920
Practice Address - Fax:866-550-4794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty