# GERARDO CANCHOLA MD, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487191516
- **Authorized official:** GERARDO CANCHOLA M.D. (OWNER)
- **Authorized official phone:** (714) 662-7710

## Contact information

- **Practice address:** 2621 S BRISTOL ST STE 308, SANTA ANA, CA 92704-5719
- **Practice address phone:** (714) 662-7710
- **Practice address fax:** (714) 662-4407
- **Mailing address:** 2621 S BRISTOL ST STE 308, SANTA ANA, CA 92704-5719
- **Mailing address phone:** (714) 662-7710
- **Mailing address fax:** (714) 662-4407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | G55328 | CA | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2017
- **Last updated:** 11/15/2022