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Organization
GATEWAY MEDICAL SERVICES, INC.
Active
Organization
GATEWAY MEDICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY LOCKHART REGUERA NP (OWNER)
(530) 515-4202
Entity
Organization
Contact information
Practice address
9461 DESCHUTES RD, UNIT 4, PALO CEDRO, CA 96073-9761
(530) 365-1833
(530) 365-5186
Mailing address
3082 MCMURRAY DRIVE, ANDERSON, CA 96007
(530) 365-1833
(530) 365-5186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
246XS1301X
Sonography Specialist/Technologist Cardiovascular
—
—
2471C3402X
Radiography Radiologic Technologist
—
—
2471S1302X
Sonography Radiologic Technologist
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
—
—
261Q00000X
Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
05/05/2014
Last updated
08/11/2015
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