Basic Information
| Provider Information | |||||||||
| NPI: | 1447212691 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GINSBURG | ||||||||
| FirstName: | JERRY | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 SAN JOSE ST | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939013901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316491000 | ||||||||
| FaxNumber: | 8316494962 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 SAN JOSE ST | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939013901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317582100 | ||||||||
| FaxNumber: | 8317581565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2006 | ||||||||
| LastUpdateDate: | 05/08/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | G210140 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RC0000X | G210140 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 00G210140 | 05 | GA | MEDICAID |