Individual
ALBERTO GAMBOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7533 NW 116TH ST, OKLAHOMA CITY, OK 73162-1336
(405) 922-2554
Mailing address
7533 NW 116TH ST, OKLAHOMA CITY, OK 73162
(405) 922-2554
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
OK
Enumeration date
03/17/2014
Last updated
03/17/2014
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