Howard Jay Congress, M.D.

Individual provider Active NPI Gastroenterology Physician · Palm Springs, CA

NPI 1104874593 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104874593
Entity type
Individual (NPI type 1)
Primary specialty
Gastroenterology Physician 207RG0100X
License
C042254 (CA)
Practice address
555 E Tachevah Dr
1E 204
Palm Springs, CA 92262-5750
Phone
(760) 778-6153
Fax
(760) 778-6785
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C042254CAMDGastroenterology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X C042254 CA Yes

Addresses

Primary practice location

555 E Tachevah Dr
1E 204
Palm Springs, CA 92262-5750

Mailing address

7 Waterloo CT
Rancho Mirage, CA 92270-1663
Phone (760) 328-6224

Other identifiers

IdentifierTypeStateIssuer
00C422540MedicaidCA

Other providers in Palm Springs, CA

All providers in Palm Springs, CA · Gastroenterology Physician in California

Sources for this page

Verify at the official NPI Registry.