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General NPI Number Information
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NPI Number | 1932362811
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Entity Type | Organization
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Legal Business Name | JERALD D. WHITE, MD, AMC
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 3231 WARING CT STE E
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City | OCEANSIDE
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State | CA
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Zip | 92056-4510
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Country | US
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Telephone | 760-726-7373
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Fax |
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Provider Business Mailing Address
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Address Line | 3231 WARING CT STE E
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City | OCEANSIDE
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State | CA
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Zip | 92056-4510
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Country | US
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Telephone | 760-726-7373
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JERALD D WHITE
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Credential | M.D.
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Telephone | 760-726-7373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G9677
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License Number State | CA
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