Provider Demographics
NPI:1255430815
Name:GAEDE, JAMES E (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:GAEDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1555 S PALM CANYON DR BLDG C
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-8354
Mailing Address - Country:US
Mailing Address - Phone:760-969-7770
Mailing Address - Fax:760-969-7771
Practice Address - Street 1:1555 S PALM CANYON DR BLDG C
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-8354
Practice Address - Country:US
Practice Address - Phone:760-969-7770
Practice Address - Fax:760-969-7771
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2020-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG86232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D28468Medicare UPIN