Individual
ODECIR ELISHA GOCKING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
43419 ALTO DR, HEMET, CA 92544-6638
(386) 503-2216
Mailing address
43419 ALTO DR, HEMET, CA 92544-6638
(386) 503-2216
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
95023201
CA
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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