Provider Demographics
NPI:1912362252
Name:GINGER.IO OF CALIFORNIA MEDICAL PC
Entity Type:Organization
Organization Name:GINGER.IO OF CALIFORNIA MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CROMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-446-4374
Mailing Address - Street 1:2415 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-4009
Mailing Address - Country:US
Mailing Address - Phone:855-446-4374
Mailing Address - Fax:415-891-0725
Practice Address - Street 1:2415 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-4009
Practice Address - Country:US
Practice Address - Phone:855-446-3747
Practice Address - Fax:415-891-0725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty