Provider Demographics
NPI:1033890199
Name:GEE, CLIFFORD (DMD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:
Last Name:GEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:SYED
Other - Middle Name:RAHEEM
Other - Last Name:AZAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8720 ARIVA CT APT 424
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2287
Mailing Address - Country:US
Mailing Address - Phone:916-295-4950
Mailing Address - Fax:
Practice Address - Street 1:1975 GARNET AVE STE E
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3594
Practice Address - Country:US
Practice Address - Phone:858-866-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108943122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist