Individual
BRYANT GAMBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
11262 CAMPUS STREET, WEST HALL L, LOMA LINDA, CA 92350
(909) 558-4923
Mailing address
11262 CAMPUS ST, LOMA LINDA, CA 92350-1727
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95018800
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2020
Last updated
03/14/2022
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