Gerald Leray Nissen, DC is a
Radiologic Technologist - Radiography based in Mojave, California. Gerald Leray Nissen is licensed to practice in California (license number RHC126137) and his current practice location is
16916 State Highway 14, Mojave, California. He can be reached at his office (for appointments etc.) via phone at
(661) 824-9732.
NPI number for Gerald Leray Nissen is 1720018435 and his current mailing address is 16916 State Highway 14, Mojave, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1720018435.
Healthcare Provider's Profile
Full Name | Gerald Leray Nissen |
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Gender | Male |
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Speciality | Radiologic Technologist - Radiography |
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Location | 16916 State Highway 14, Mojave, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1720018435
- Provider Enumeration Date: 07/05/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Gerald Leray Nissen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720018435 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
111NR0200X | Chiropractor - Radiology | DC16780 (California) | Primary |
2471C3402X | Radiologic Technologist - Radiography | RHC126137 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gerald Leray Nissen is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gerald Leray Nissen, DC 16916 State Highway 14, Mojave, CA 93501-1226 Ph: (661) 824-9732 | Gerald Leray Nissen, DC 16916 State Highway 14, Mojave, CA 93501-1226 Ph: (661) 824-9732 |
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