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Individual
MR. JULIO C GAMBOA
Active
Individual
MR. JULIO C GAMBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5594459083
CONTACT
CA
01
—
5594459094
CONTACT
CA
Enumeration date
02/21/2020
Last updated
06/29/2023
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