Provider Demographics
NPI:1720024441
Name:WEEKS, GERALD COLBORNE II (DC)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:COLBORNE
Last Name:WEEKS
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28009 CAMINO DEL RIO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-5375
Mailing Address - Country:US
Mailing Address - Phone:949-661-8116
Mailing Address - Fax:714-741-0325
Practice Address - Street 1:12511 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4806
Practice Address - Country:US
Practice Address - Phone:714-741-0330
Practice Address - Fax:714-741-0325
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC21553AMedicare ID - Type Unspecified