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
| License | State | Type | Specialty |
|---|---|---|---|
| C042254 | CA | MD | Gastroenterology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C422540 | Medicaid | CA |
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All providers in Palm Springs, CA · Gastroenterology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.