Provider Demographics
NPI:1225278120
Name:HURLEY GASTROENTEROLOGY, INC.
Entity Type:Organization
Organization Name:HURLEY GASTROENTEROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:G
Authorized Official - Last Name:RIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-327-5300
Mailing Address - Street 1:1180 N. INDIAN CANYON DRIVE
Mailing Address - Street 2:SUITE E318
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4809
Mailing Address - Country:US
Mailing Address - Phone:760-327-5300
Mailing Address - Fax:760-327-5307
Practice Address - Street 1:1180 N. INDIAN CANYON DRIVE
Practice Address - Street 2:SUITE E318
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4809
Practice Address - Country:US
Practice Address - Phone:760-327-5300
Practice Address - Fax:760-327-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG88404207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty