Individual
DR. JAY MICHAEL GOSPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 PAMELA DR, SANTA ROSA, CA 95404-3140
(707) 542-8474
(707) 595-5117
Mailing address
1701 PAMELA DR, SANTA ROSA, CA 95404-3140
(707) 542-8474
(707) 595-5117
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G11211
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G11211
CALIFORNIA STATE LICENSE
CA
Enumeration date
01/05/2012
Last updated
01/05/2012
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