Cavanaugh, Gary Lynn

Cavanaugh, Gary Lynn is an individual health care provider with primary practice located at 2522 Grand Canal Blvd #1, Stockton CA 95207-8213. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Cavanaugh, Gary Lynn can be contacted via phone (209) 951-4666.

Contact Information

Primary practice address
2522 Grand Canal Blvd #1 Stockton CA 95207-8213
Phone: (209) 951-4666
Fax: (209) 951-5829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X C34330 California

Profile Details

NPI number 1619087038
LBN Legal business name Cavanaugh, Gary Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619087038 NPPES
California MEDICAID 00C343300

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