Individual
GABRIEL SOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1114 6TH ST, MODESTO, CA 95354-2203
(866) 682-4842
(877) 436-1494
Mailing address
737 W CHILDS AVE, MERCED, CA 95341-6805
(866) 682-4842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
58744
CA
Other
Enumeration date
07/17/2020
Last updated
11/30/2020
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