Provider Demographics
NPI:1215935713
Name:GANEY, JOHN T (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:GANEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4721 DALLAS RANCH ROAD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8811
Mailing Address - Country:US
Mailing Address - Phone:925-778-0679
Mailing Address - Fax:925-778-3567
Practice Address - Street 1:4721 DALLAS RANCH ROAD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8811
Practice Address - Country:US
Practice Address - Phone:925-778-0679
Practice Address - Fax:925-778-3567
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG83253207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G832530Medicare PIN
CAG05868Medicare UPIN
CA6217260001Medicare NSC