1013226315 NPI number — DR. ANTHONY GEORGE GANEM D.C.

Table of content: DR. ANTHONY GEORGE GANEM D.C. (NPI 1013226315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013226315 NPI number — DR. ANTHONY GEORGE GANEM D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GANEM
Provider First Name:
ANTHONY
Provider Middle Name:
GEORGE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GANEM
Provider Other First Name:
TONY
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1013226315
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3000 W MACARTHUR BLVD
Provider Second Line Business Mailing Address:
SUITE 530
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92704-6916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-210-2827
Provider Business Mailing Address Fax Number:
714-210-2850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3000 W MACARTHUR BLVD
Provider Second Line Business Practice Location Address:
SUITE 530
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92704-6916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-210-2827
Provider Business Practice Location Address Fax Number:
714-210-2850
Provider Enumeration Date:
10/04/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC27763 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111NN1001X , with the licence number: DC27763 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)