Provider Demographics
NPI:1790913598
Name:WARNER, GERALD JOSEPH (RN)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:JOSEPH
Last Name:WARNER
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 1:286 EUCLID AVE
Mailing Address - Street 2:102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-3610
Mailing Address - Country:US
Mailing Address - Phone:619-266-2111
Mailing Address - Fax:619-266-0496
Practice Address - Street 1:286 EUCLID AVE
Practice Address - Street 2:102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-3610
Practice Address - Country:US
Practice Address - Phone:619-266-2111
Practice Address - Fax:619-266-0496
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515002163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse