Gjerdrum, Thor C

Gjerdrum, Thor C is an individual health care provider with primary practice located at 300 South Stratford Avenue , Santa Maria CA 93454-5903. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Gjerdrum, Thor C can be contacted via phone (805) 739-3863.

Contact Information

Primary practice address
300 South Stratford Avenue Santa Maria CA 93454-5903
Phone: (805) 739-3863
Fax: (805) 614-2035
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X G16055 California

Profile Details

NPI number 1407830177
LBN Legal business name Gjerdrum, Thor C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Feb 15th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407830177 NPPES
California Other WG16055I MEDICARE ID
California Other ZZZ06481Z MEDICARE ID
California MEDICAID 00G160550 MEDICARE ID

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