Provider Demographics
NPI:1932218963
Name:CZER, GREGORY T (MD)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:T
Last Name:CZER
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 1:754 MEDICAL CENTER CT
Mailing Address - Street 2:100
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911
Mailing Address - Country:US
Mailing Address - Phone:619-421-4000
Mailing Address - Fax:619-421-6395
Practice Address - Street 1:754 MEDICAL CENTER CT
Practice Address - Street 2:100
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911
Practice Address - Country:US
Practice Address - Phone:619-421-4000
Practice Address - Fax:619-421-6395
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41079207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
W10946OtherMEDICARE TRANSFER #
A89721Medicare UPIN
CAWG41079AMedicare PIN