Provider Demographics
NPI:1891771846
Name:MONASH, GARY RONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:RONALD
Last Name:MONASH
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 1:7566 N LA CHOLLA BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2307
Mailing Address - Country:US
Mailing Address - Phone:520-742-4139
Mailing Address - Fax:520-742-9618
Practice Address - Street 1:7566 N LA CHOLLA BLVD
Practice Address - Street 2:STE A
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2307
Practice Address - Country:US
Practice Address - Phone:520-742-4139
Practice Address - Fax:520-742-9618
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13401207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z0218OtherHEALTHNET
AZAZ0079490OtherBLUE CROSS BLUE SHIELD AZ
AZ223595Medicaid
AZ4094885OtherAETNA
AZ10WCHKN02Medicare ID - Type UnspecifiedNORIDIAN
AZ4094885OtherAETNA