Individual
ANTHONY J GANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
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
Update your record
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