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General NPI Number Information
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NPI Number | 1831056472
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Entity Type | Individual
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Provider Name | GARY CARL GEROZA PTA
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Gender | Male
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 27450 YNEZ RD STE 120
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City | TEMECULA
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State | CA
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Zip | 92591-4649
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Country | US
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Telephone | 951-498-7540
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Fax |
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Provider Business Mailing Address
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Address Line | 36025 ARRAS DR
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City | WINCHESTER
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State | CA
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Zip | 92596-8733
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Country | US
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Telephone | 951-365-7001
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 54447
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License Number State | CA
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