Organization
GABRIEL ZACHARIA REAGLE DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL ZACHARIA REAGLE DO (CEO)
(805) 503-5312
Entity
Organization
Contact information
Practice address
1400 E CHURCH ST, SANTA MARIA, CA 93454-5906
(805) 503-5312
(805) 973-2322
Mailing address
4554 WAVERTREE ST, SAN LUIS OBISPO, CA 93401-7831
(805) 503-5312
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A10912
DO LICENSE
CA
Enumeration date
05/30/2019
Last updated
06/18/2019
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