Provider Demographics
NPI:1811991847
Name:MICHAEL R. GATTO MD, INC.
Entity type:Organization
Organization Name:MICHAEL R. GATTO MD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GATTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-323-4735
Mailing Address - Street 1:1180 N INDIAN CANYON DR
Mailing Address - Street 2:STE E311
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4809
Mailing Address - Country:US
Mailing Address - Phone:760-323-4735
Mailing Address - Fax:760-323-1167
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:STE E311
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4809
Practice Address - Country:US
Practice Address - Phone:760-323-4735
Practice Address - Fax:760-323-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35026207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10951160OtherCAQH
CAZZZ05643ZOtherMEDICARE PTAN
A46187Medicare UPIN
CA10951160OtherCAQH