Basic Information
Provider Information
NPI: 1164473807
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GANZHORN
FirstName: FRANK
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 4363
Address2:  
City: SALINAS
State: CA
PostalCode: 939124363
CountryCode: US
TelephoneNumber: 8317572058
FaxNumber: 8317570232
Practice Location
Address1: 1033 LOS PALOS DR
Address2:  
City: SALINAS
State: CA
PostalCode: 939013916
CountryCode: US
TelephoneNumber: 8317572058
FaxNumber: 8317570232
Other Information
ProviderEnumerationDate: 05/15/2006
LastUpdateDate: 06/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XG25330CAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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