Provider Demographics
NPI:1093755159
Name:HYDE, GILBERT LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:LAWRENCE
Last Name:HYDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:47647 CALEO BAY DR STE 210
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-8858
Mailing Address - Country:US
Mailing Address - Phone:760-760-5649
Mailing Address - Fax:
Practice Address - Street 1:47647 CALEO BAY DR STE 210
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253
Practice Address - Country:US
Practice Address - Phone:760-760-5649
Practice Address - Fax:760-771-9001
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2018-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC51007207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB04745Medicare UPIN