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General NPI Number Information
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NPI Number | 1336227792
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Entity Type | Organization
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Legal Business Name | JERROLD CANTOR, MD, INC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2621 S BRISTOL ST STE 305
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City | SANTA ANA
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State | CA
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Zip | 92704-5719
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Country | US
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Telephone | 714-751-0034
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Fax |
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Provider Business Mailing Address
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Address Line | 2621 S BRISTOL ST STE 305
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City | SANTA ANA
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State | CA
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Zip | 92704-5719
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Country | US
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Telephone | 714-751-0034
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JERROLD D CANTOR
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Credential | MD
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Telephone | 714-751-0034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G23528
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License Number State | CA
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