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General NPI Number Information
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NPI Number | 1750560710
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Entity Type | Organization
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Legal Business Name | SANFORD H GAYNOR, M.D.,INC.
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 1045 W REDONDO BEACH BLVD SUITE 115
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City | GARDENA
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State | CA
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Zip | 90247-4128
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Country | US
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Telephone | 310-527-7355
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Fax | 310-527-2528
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Provider Business Mailing Address
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Address Line | 1045 W REDONDO BEACH BLVD SUITE 115
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City | GARDENA
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State | CA
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Zip | 90247-4128
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Country | US
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Telephone | 310-527-7355
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Fax | 310-527-2528
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANFORD H GAYNOR
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Credential | M.D.
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Telephone | 310-527-7355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | G6215
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License Number State | CA
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