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Individual

DR. GERALD D. EBNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1418 E MAIN ST, STE 210, SANTA MARIA, CA 93454-4833
(805) 928-3678
(805) 928-6408
Mailing address
2050 S BLOSSER RD, SANTA MARIA, CA 93458-7310
(805) 361-8028
(805) 361-8097

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G25834
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G258340
CA
01
180015121
MEDICARE RAILROAD
CA
Enumeration date
05/23/2005
Last updated
06/09/2015
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