Provider Demographics
NPI:1275992422
Name:DR CHRISTINE GERGES MD INC.
Entity Type:Organization
Organization Name:DR CHRISTINE GERGES MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-222-9695
Mailing Address - Street 1:PO BOX 28325
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0144
Mailing Address - Country:US
Mailing Address - Phone:714-222-9695
Mailing Address - Fax:
Practice Address - Street 1:4100 CENTRAL AVE STE 106
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2930
Practice Address - Country:US
Practice Address - Phone:951-788-0008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94159261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care