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General NPI Number Information
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NPI Number | 1174984579
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Entity Type | Organization
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Legal Business Name | THE GARY CENTER
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 1525 17TH ST,
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City | SANTA ANA
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State | CA
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Zip | 92705
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Country | US
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Telephone | 714-542-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 341 S. HILLCREST ST
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City | LA HABRA
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State | CA
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Zip | 90631
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Country | US
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Telephone | 562-691-3263
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Fax |
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Authorized Official
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Title or Position | INTERN
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Name | RAMONA ROBERTS
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Credential |
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Telephone | 714-542-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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