Individual
GAVIN T TABLADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
7575 N DEL MAR AVE STE 101, FRESNO, CA 93711-6857
(559) 431-7045
Mailing address
7575 N DEL MAR AVE STE 101, FRESNO, CA 93711-6857
(559) 431-7045
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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