Provider Demographics
NPI:1447362520
Name:ADEY, GEOFFREY ROBERT (MD)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:ROBERT
Last Name:ADEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1101 SE TECH CENTER DRIVE
Mailing Address - Street 2:SUITE #155
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5521
Mailing Address - Country:US
Mailing Address - Phone:360-514-9040
Mailing Address - Fax:360-514-9041
Practice Address - Street 1:1455 MONTEGO STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-937-0404
Practice Address - Fax:925-937-1340
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG82135207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG82135OtherBLUE CROSS OF CA
P00052861OtherRAILROAD MEDICARE
CA00G821350Medicaid
P00052861OtherRAILROAD MEDICARE
CA00G821350Medicare ID - Type Unspecified