Individual
STANTON GERALD AXLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 SANTA MONICA BLVD, 665W, SANTA MONICA, CA 90404-2102
(310) 829-0919
(310) 829-1260
Mailing address
2001 SANTA MONICA BLVD, 665W, SANTA MONICA, CA 90404-2102
(310) 829-0919
(310) 829-1260
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
C23954
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C23954
MEDICAL LICENSE
CA
Enumeration date
12/29/2006
Last updated
02/21/2014
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