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General NPI Number Information
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NPI Number | 1881900116
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Entity Type | Organization
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Legal Business Name | GERARDO M GENERAL MD INC
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 5385 WALNUT AVE # 5
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City | CHINO
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State | CA
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Zip | 91710-2605
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Country | US
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Telephone | 909-465-6464
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Fax | 909-465-9544
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Provider Business Mailing Address
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Address Line | PO BOX 2735
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City | CHINO
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State | CA
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Zip | 91708-2735
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Country | US
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Telephone | 909-465-6464
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Fax | 909-465-9544
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Authorized Official
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Title or Position | OWNER
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Name | GERARDO M GENERAL
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Credential | MD
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Telephone | 909-465-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A51732
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License Number State | CA
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