Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | G73203 | CA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | G73203 | CA |
NPI | 1538105739 |
---|---|
Provider Name | Dr. Andrew Paul Gerken |
First Address | Newport Beach, CA 92660-7901 |
Second Address | Newport Beach, CA 92660-7901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 17/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G14298 | (02) | CA |
GU960Z | (02) | CA |