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General NPI Number Information
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NPI Number | 1053708990
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Entity Type | Organization
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Legal Business Name | GARY M. WERNICK, M.D., INC
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Dates
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Enumeration Date | 04/17/2015
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 10408 INDUSTRIAL CIR
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City | REDLANDS
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State | CA
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Zip | 92374-4548
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Country | US
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Telephone | 909-796-7803
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Fax | 909-255-7287
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Provider Business Mailing Address
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Address Line | 10408 INDUSTRIAL CIR
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City | REDLANDS
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State | CA
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Zip | 92374-4548
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Country | US
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Telephone | 909-796-7803
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Fax | 909-255-7287
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY M WERNICK
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Credential | MS
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Telephone | 909-796-7803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G35936
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License Number State | CA
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