Provider Demographics
NPI:1073605473
Name:SIGALA, JERALD FREDRICK (MD)
Entity Type:Individual
Prefix:
First Name:JERALD
Middle Name:FREDRICK
Last Name:SIGALA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1310 W STEWART DR
Mailing Address - Street 2:SUITE 607
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3854
Mailing Address - Country:US
Mailing Address - Phone:714-639-4901
Mailing Address - Fax:714-771-5389
Practice Address - Street 1:520 SUPERIOR AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3637
Practice Address - Country:US
Practice Address - Phone:949-631-9215
Practice Address - Fax:949-631-4576
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG33210207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG33210BMedicare PIN
CAWG33210AMedicare PIN