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Individual

MR. GERARD PAUL STANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
2900 E DEL MAR BLVD, PASADENA, CA 91107-4375
(626) 272-0495
(626) 356-2621
Mailing address
2900 E DEL MAR BLVD, PASADENA, CA 91107-4375
(626) 795-9901
(626) 272-2621

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
572022
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
572022
REGISTERED NURSE
CA
Enumeration date
09/21/2021
Last updated
09/21/2021
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