Individual
GLORIA FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16378 E 14TH ST STE 202, SAN LEANDRO, CA 94578-5122
(510) 205-9048
Mailing address
16378 E 14TH ST STE 202, SAN LEANDRO, CA 94578-5122
(510) 205-9048
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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