Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GERALD LERAY NISSEN, D.C.
Active Sole ProprietorGERALD LERAY NISSEN, D.C. is a 2471C3402X healthcare provider located in MOJAVE, California. NPI 1720018435 is currently active in the NPPES registry. Verify at CMS.
2471C3402X · MOJAVE, CA
Registration Details
- NPI Number
- 1720018435
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 5, 2006 (20.119462568224 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
DC16780 (CA)RHC126137 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
16916 STATE HIGHWAY 14MOJAVE, CA, 935011226Browse CA providers · Browse ZIP 93501
- Phone
- 6618249732
- Fax
- 6618241638
- Primary Specialty
-
2471C3402X
2471C3402X
- Additional Specialty
- 2471C3402X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.