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General NPI Number Information
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NPI Number | 1568583201
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Entity Type | Individual
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Provider Name | GERALD DENNIS MAIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 602 EXETER LANE
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City | CAMBRIA
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State | CA
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Zip | 93428
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Country | US
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Telephone | 805-927-3713
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1462
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City | CAMBRIA
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State | CA
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Zip | 93428-1462
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Country | US
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Telephone | 805-927-3713
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | A24331
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A24331
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License Number State | CA
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