Individual
ANITA KAY GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1010 W LA VETA AVE, SUITE 470, ORANGE, CA 92868-4304
(714) 835-8300
(714) 835-8304
Mailing address
1010 W LA VETA AVE, SUITE 470, ORANGE, CA 92868-4304
(714) 835-8300
(714) 835-8304
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
G74192
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G741920
BLUE SHIELD
CA
Enumeration date
03/30/2006
Last updated
02/03/2022
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