Provider Demographics
NPI:1942461397
Name:GE MEDICAL SERVICES
Entity Type:Organization
Organization Name:GE MEDICAL SERVICES
Other - Org Name:GE MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-851-4797
Mailing Address - Street 1:1117 DESERT LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2305
Mailing Address - Country:US
Mailing Address - Phone:800-498-1081
Mailing Address - Fax:
Practice Address - Street 1:269 S BEVERLY DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3851
Practice Address - Country:US
Practice Address - Phone:800-498-1081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-18
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA28026208VP0000X
261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty