Individual
TERRY GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
18646 OXNARD ST, TARZANA, CA 91356-1411
(818) 996-1051
Mailing address
18646 OXNARD ST, TARZANA, CA 91356-1411
(818) 996-1051
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
95188180
CA
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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