Individual
MR. GARY MARK AGCAOILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.T.R.S
Contact information
Practice address
4150 CLEMENT ST, SAN FRANCISCO, CA 94121-1545
(415) 221-4810
Mailing address
3520 PARK RIDGE DR, RICHMOND, CA 94806-5824
(510) 685-5206
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
32223
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32223
RECREATION THERAPIST
CA
Enumeration date
07/28/2006
Last updated
07/08/2007
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