Provider Demographics
NPI:1073844197
Name:IVOR L. GEFT, M.D. A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:IVOR L. GEFT, M.D. A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IVOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:GEFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-659-7537
Mailing Address - Street 1:8631 W. THIRD ST #445E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-659-7537
Mailing Address - Fax:310-289-7941
Practice Address - Street 1:8631 W. THIRD ST #445E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-659-7537
Practice Address - Fax:310-289-7941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37160207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A371600Medicaid
CAA84977Medicare UPIN