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Organization
EPC SC ACO LLC
Active
Organization
EPC SC ACO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO GAMBOA MD (OWNER)
(737) 226-6700
Entity
Organization
Contact information
Practice address
2375 BAKER HOSPITAL BLVD, NORTH CHARLESTON, SC 29405-8233
(737) 226-6700
Mailing address
3901A SPICEWOOD SPRINGS RD STE 201, AUSTIN, TX 78759-8728
(737) 226-6700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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