Individual
GABRIEL PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 STATION WAY STE E, ARROYO GRANDE, CA 93420-3348
(805) 202-7336
(805) 202-7153
Mailing address
200 STATION WAY STE E, ARROYO GRANDE, CA 93420-3348
(805) 202-7336
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95019600
CA
363LG0600X
Gerontology Nurse Practitioner
95019600
CA
363LP2300X
Primary Care Nurse Practitioner
95019600
CA
Other
Enumeration date
01/10/2022
Last updated
10/19/2023
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