Provider Demographics
NPI:1235238304
Name:GEIER, JOHN WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:GEIER
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 1:24411 HEALTH CENTER DRIVE
Mailing Address - Street 2:SUITE 460
Mailing Address - City:LAGUNG HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3687
Mailing Address - Country:US
Mailing Address - Phone:949-452-7710
Mailing Address - Fax:949-452-7797
Practice Address - Street 1:24411 HEALTH CENTER DRIVE
Practice Address - Street 2:SUITE 460
Practice Address - City:LAGUNG HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3687
Practice Address - Country:US
Practice Address - Phone:949-452-7710
Practice Address - Fax:949-452-7797
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53154207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A53154Medicare ID - Type Unspecified
G34871Medicare UPIN