Henderson, Gregory Philip

Henderson, Gregory Philip is an individual health care provider with primary practice located at 1441 Avocado Ave Ste 409 , Newport Beach CA 92660-7705. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Henderson, Gregory Philip can be contacted via phone (949) 640-4501.

Contact Information

Primary practice address
1441 Avocado Ave Ste 409 Newport Beach CA 92660-7705
Phone: (949) 640-4501
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X A125261 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X A125261 California

Profile Details

NPI number 1619109519
LBN Legal business name Henderson, Gregory Philip
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2009
Last updated Jun 18th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619109519 NPPES
Minnesota MEDICAID ENROLLED
Minnesota Other P00940083
Minnesota MEDICAID ENROLLED

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