Provider Demographics
NPI:1710491436
Name:DENNEY, GERALD DAVID (RN)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:DAVID
Last Name:DENNEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23319 AUDREY AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3711
Mailing Address - Country:US
Mailing Address - Phone:310-753-6716
Mailing Address - Fax:310-634-0358
Practice Address - Street 1:23319 AUDREY AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3711
Practice Address - Country:US
Practice Address - Phone:310-753-6716
Practice Address - Fax:310-634-0358
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA756944163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse