| Gnosis Geriatric Wellcare Center Inc | |
|
12555 Garden Grove Blvd Ste 304 Garden Grove CA 92843-1903 | |
| (714) 353-5333 | |
| Not Available |
| Full Name | Gnosis Geriatric Wellcare Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 12555 Garden Grove Blvd Ste 304, Garden Grove, California |
| Authorized Official Name and Position | Gerardo Canchola (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7143535333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gnosis Geriatric Wellcare Center Inc 2617 E Chapman Ave Orange CA 92869-3226 Ph: () - | Gnosis Geriatric Wellcare Center Inc 12555 Garden Grove Blvd Ste 304 Garden Grove CA 92843-1903 Ph: (714) 353-5333 |
| NPI Number | 1962145029 |
|---|---|
| Provider Enumeration Date | 04/18/2022 |
| Last Update Date | 04/16/2023 |
| Medicare PECOS PAC ID | 6709242175 |
|---|---|
| Medicare Enrollment ID | O20230510002554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962145029 | NPI | - | NPPES |
| Provider Name | Gerardo Canchola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639185879 PECOS PAC ID: 0547210643 Enrollment ID: I20100628000844 |
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