Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | G35936 | CA |
NPI | 1033189808 |
---|---|
Provider Name | Dr. Gary Merle Wernick |
First Address | Redlands, CA 92374-4548 |
Second Address | Redlands, CA 92374-4548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 18/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G359360 | (05) | CA |
A46524 | (02) | CA |