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Individual

DR. ALAN E. GORENBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8506 E CHAPMAN AVE, ORANGE, CA 92869-2461
(714) 633-4666
(714) 633-4640
Mailing address
12380 HESPERIA RD STE 2, VICTORVILLE, CA 92395-5814
(760) 243-4188
(760) 243-6888

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
G60876
CA
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
G60876
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G608761
BLUE CROSS AND BLUE SHIELD
01
1730115221
NPI (INDIVIDUAL)
CA
01
1770514945
NPI (INCORPERATED)
CA
01
260035678
COMMERCIAL
01
G60876
MEDICAL LICENSE
CA
Enumeration date
06/25/2006
Last updated
10/14/2010
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