Individual
DR. JERRY PRENTISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W. HOSPITAL RD., FRENCH CAMP, CA 95231-9989
(209) 468-6937
(209) 468-7042
Mailing address
PO BOX 1020, STOCKTON, CA 95201-3120
(209) 468-6000
(209) 468-7042
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C51172
CA
207L00000X
Anesthesiology Physician
MD-2716
HI
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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