Provider Demographics
NPI:1114635406
Name:JOY, GREGORY AUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:AUSTIN
Last Name:JOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6166 PLEASANT VALLEY RD UNIT 79
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:CA
Mailing Address - Zip Code:95623-5503
Mailing Address - Country:US
Mailing Address - Phone:530-622-9522
Mailing Address - Fax:520-626-6888
Practice Address - Street 1:6221 MONITOR RD
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:CA
Practice Address - Zip Code:95623-4534
Practice Address - Country:US
Practice Address - Phone:530-622-9522
Practice Address - Fax:530-626-6888
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC29503207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine