Provider Demographics
NPI:1710929179
Name:GARBIN, GREGORY STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:STEVEN
Last Name:GARBIN
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 1:210 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3807
Mailing Address - Country:US
Mailing Address - Phone:714-347-1010
Mailing Address - Fax:714-647-1245
Practice Address - Street 1:200 PORTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1587
Practice Address - Country:US
Practice Address - Phone:925-838-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63967207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G639670Medicaid
CAAW503YMedicare PIN
CAAW503XMedicare PIN
CA00G639670Medicaid
CA00G639670Medicare PIN
CAP00748802Medicare PIN
CABB745ZMedicare PIN
CAAW503VMedicare PIN