Brennock, Gerald M
Brennock, Gerald M is an individual health care provider with primary practice located at 26732 Crown Valley Pkwy Suite 131, Mission Viejo CA 92691-6306. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Brennock, Gerald M can be contacted via phone (949) 364-6000.Contact Information
Primary practice address
26732 Crown Valley Pkwy Suite 131
Mission Viejo CA 92691-6306
Phone: (949) 364-6000
Fax: (949) 364-9561
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G12527 | California |
Profile Details
| NPI number | 1912983198 |
|---|---|
| LBN Legal business name | Brennock, Gerald M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912983198 | NPPES |
| California | MEDICAID | 00G125270 |
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