Provider Demographics
NPI:1649243437
Name:GEARE, JOSEPH (PA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:GEARE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 E. HWY 20
Mailing Address - Street 2:LUCERNE COMMUNITY CLINIC,
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458-0000
Mailing Address - Country:US
Mailing Address - Phone:101-274-9299
Mailing Address - Fax:707-274-9297
Practice Address - Street 1:6300 E. HWY 20
Practice Address - Street 2:
Practice Address - City:LUCERNE
Practice Address - State:CA
Practice Address - Zip Code:95458
Practice Address - Country:US
Practice Address - Phone:101-274-9299
Practice Address - Fax:707-274-9297
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA10013363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical