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Individual

MS. CAROLYN GAYLE GOBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2020 SANTA MONICA BLVD, SUITE 400, SANTA MONICA, CA 90404-2023
(310) 829-2663
(310) 315-2037
Mailing address
831 IDAHO AVE, SANTA MONICA, CA 90403-2804
(760) 533-9655

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
22319
CA
363AS0400X
Surgical Physician Assistant
Primary
22319
CA

Other

Enumeration date
07/12/2012
Last updated
07/12/2012
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