Provider Demographics
NPI:1346398740
Name:WHITE, GEOFFREY G (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:G
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:966 CASS ST
Mailing Address - Street 2:STE 100
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4539
Mailing Address - Country:US
Mailing Address - Phone:831-373-7733
Mailing Address - Fax:831-373-3358
Practice Address - Street 1:966 CASS ST
Practice Address - Street 2:STE 100
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4539
Practice Address - Country:US
Practice Address - Phone:831-373-7733
Practice Address - Fax:831-373-3358
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2008-02-12
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Provider Licenses
StateLicense IDTaxonomies
CAG15580207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G155800Medicaid
CO00G155800Medicare ID - Type Unspecified
CA00G155800Medicaid