Provider Demographics
NPI:1821193467
Name:GERIA, VEEJAY N (MD)
Entity Type:Individual
Prefix:DR
First Name:VEEJAY
Middle Name:N
Last Name:GERIA
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:PO BOX 3589
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-8589
Mailing Address - Country:US
Mailing Address - Phone:657-241-3600
Mailing Address - Fax:657-241-7708
Practice Address - Street 1:16200 SAND CANYON AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3714
Practice Address - Country:US
Practice Address - Phone:949-610-7245
Practice Address - Fax:657-241-7720
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0008081207R00000X
CAC129982207R00000X, 208M00000X
NJ25MA08181300208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB216524OtherMEDICARE PTAN
CAP01395655OtherMEDICARE RAILROAD
NJ0117749Medicaid
CACB216524OtherMEDICARE PTAN
I69124Medicare UPIN
DEG02723I09Medicare PIN
NJ124364YBAWMedicare PIN
NJ124364R63Medicare PIN
CACB216524Medicare PIN