Provider Demographics
NPI:1013226315
Name:GANEM, ANTHONY GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GEORGE
Last Name:GANEM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:GANEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:3000 W MACARTHUR BLVD
Mailing Address - Street 2:SUITE 530
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6916
Mailing Address - Country:US
Mailing Address - Phone:714-210-2827
Mailing Address - Fax:714-210-2850
Practice Address - Street 1:3000 W MACARTHUR BLVD
Practice Address - Street 2:SUITE 530
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6916
Practice Address - Country:US
Practice Address - Phone:714-210-2827
Practice Address - Fax:714-210-2850
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27763111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition