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Individual

JOHN GAMBOL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1041 E YORBA LINDA BLVD STE 203, PLACENTIA, CA 92870-3762
(818) 709-8161
(818) 709-8160
Mailing address
PO BOX 9126, CANOGA PARK, CA 91309-0126
(818) 709-8161
(818) 709-8160

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G87090
CA
207P00000X
Emergency Medicine Physician
ME70844
FL
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
G87090
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
261062100
FL
01
58630
GRP# 98513
FL
01
606478700
DOL GRP#
FL
01
G87090
LICENSE#
CA
01
ME70844
LICENSE#
FL
Enumeration date
07/08/2005
Last updated
12/13/2018
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