Individual
ANTHONY J GANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
173 SANTA ANA AVE, LONG BEACH, CA 90803-3461
(714) 657-0687
Mailing address
173 SANTA ANA AVE, LONG BEACH, CA 90803-3461
(714) 657-0687
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95091739
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B3382459
CALIFORNIA DRIVERS LICENSE
CA
Enumeration date
11/26/2018
Last updated
11/26/2018
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