Individual
DR. GILBERT RIENZIE FERNANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18350 ROSCOE BLVD, #714, NORTHRIDGE, CA 91325-4109
(818) 727-7073
Mailing address
18350 ROSCOE BLVD, #714, NORTHRIDGE, CA 91325-4109
(818) 727-7073
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
C40808
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C408080
—
CA
Enumeration date
10/11/2006
Last updated
07/08/2007
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