Provider Demographics
NPI:1124021654
Name:GINSBURG, GREGORY T (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:T
Last Name:GINSBURG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3531 FASHION WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-3809
Mailing Address - Country:US
Mailing Address - Phone:310-372-4500
Mailing Address - Fax:310-372-4505
Practice Address - Street 1:3531 FASHION WAY STE 3
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-3809
Practice Address - Country:US
Practice Address - Phone:310-372-4500
Practice Address - Fax:310-372-4505
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-30
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74789163WW0000X, 2086X0206X, 208C00000X, 208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18614OtherMEDICARE
CA00G747892Medicaid
H19460Medicare UPIN