Provider Demographics
NPI:1144218512
Name:GASTROENTEROLOGY CONSULTANTS, LTD
Entity Type:Organization
Organization Name:GASTROENTEROLOGY CONSULTANTS, LTD
Other - Org Name:GI CONSULTANTS, LTD.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:OSGARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-329-4600
Mailing Address - Street 1:PO BOX 842664
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90084-2664
Mailing Address - Country:US
Mailing Address - Phone:775-329-4600
Mailing Address - Fax:775-324-4314
Practice Address - Street 1:880 RYLAND ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1603
Practice Address - Country:US
Practice Address - Phone:775-329-4600
Practice Address - Fax:775-329-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV050929200530225174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506148Medicaid
NV100506148Medicaid