Van Dyke, Gerald (Gerry) C

Van Dyke, Gerald (Gerry) C is an individual health care provider with primary practice located at 6193 Soquel Dr , Aptos CA 95003-3116. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, which is considered as his primary health care specialty. Van Dyke, Gerald (Gerry) C can be contacted via phone (831) 462-1212.

Contact Information

Primary practice address
6193 Soquel Dr Aptos CA 95003-3116
Phone: (831) 462-1212
Fax: (831) 462-1221
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X PT13181 California

Profile Details

NPI number 1659318673
LBN Legal business name Van Dyke, Gerald (Gerry) C
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Aug 19th, 2013 - about 12 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 1659318673 NPPES
California Other 650009364 RAILROAD MEDICARE
California Other 770393462 RAILROAD MEDICARE
California MEDICAID PT0131810 RAILROAD MEDICARE
California Other ZZZ45601Z RAILROAD MEDICARE

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