Individual
MR. EDMOND GAPUSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
470 ASSEMBLY AVE, SANTA CRUZ, CA 95062-3939
(559) 892-5674
Mailing address
470 ASSEMBLY AVE, SANTA CRUZ, CA 95062-3939
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/28/2011
Last updated
03/28/2011
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