Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 33387 | CA |
NPI | 1184078859 |
---|---|
Provider Name | Dr. Gerald Ferencz |
First Address | Santa Ana, CA 92705-2128 |
Second Address | Santa Ana, CA 92701-3147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2016 |
Last Update Date | 16/05/2021 |