Individual
DR. LARRY KYLE GAMBRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6880 PALM AVENUE, SEBASTOPOL, CA 95472
(707) 823-7628
(707) 823-1521
Mailing address
6880 PALM AVE, SEBASTOPOL, CA 95472-4270
(707) 823-7628
(707) 823-1521
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
20A9837
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA107813
MEDICARE
CA
Enumeration date
10/10/2006
Last updated
03/03/2015
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