Individual
GABRIEL WILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 S HALCYON RD, ARROYO GRANDE, CA 93420-3817
(408) 355-4624
Mailing address
PO BOX 324, DANVILLE, CA 94526-0324
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A181816
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2019
Last updated
07/13/2023
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