# JOSE C. GAMBOA, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639243769
- **Authorized official:** JOSE CAGUIAT GAMBOA M.D. (PRESIDENT-C.E.O.)
- **Authorized official phone:** (714) 935-7684

## Contact information

- **Practice address:** 1020 S ANAHEIM BLVD, SUITE 214, ANAHEIM, CA 92805-5851
- **Practice address phone:** (714) 935-7684
- **Practice address fax:** (714) 776-0230
- **Mailing address:** PO BOX 6334, ANAHEIM, CA 92816-0334
- **Mailing address phone:** (714) 935-7684
- **Mailing address fax:** (714) 776-0230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | A45291 | CA | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 07/30/2009