Provider Demographics
NPI:1134540396
Name:BELJAN, GERALD (RCP)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:
Last Name:BELJAN
Suffix:
Gender:M
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31847 CORTE MENDOZA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3528
Mailing Address - Country:US
Mailing Address - Phone:951-283-8966
Mailing Address - Fax:
Practice Address - Street 1:31847 CORTE MENDOZA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-3528
Practice Address - Country:US
Practice Address - Phone:951-283-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15317227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered