Individual provider · Type 1 NPI
Yonathan Gamboa
Dental Clinic/Center · Stockton, CA
NPI number
1336736750
Active
Practice location
966 W Mariposa Ave
Stockton, CA 95204-3017
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
About NPI 1336736750
Yonathan Gamboa's National Provider Identifier is 1336736750, issued on Dec 31, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Stockton, CA. The record was last updated on Dec 31, 2020.