Gamboa, Jose L
Gamboa, Jose L is an individual health care provider with primary practice located at 9700 Mashburn Blvd , Oklahoma City OK 73162-5509. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, which is considered as his primary health care specialty. Gamboa, Jose L can be contacted via phone (405) 721-2466.Contact Information
Primary practice address
9700 Mashburn Blvd
Oklahoma City OK 73162-5509
Phone: (405) 721-2466
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics | 2251G0304X | 2694 | Oklahoma |
Profile Details
| NPI number | 1114549920 |
|---|---|
| LBN Legal business name | Gamboa, Jose L |
| Credentials | Physical Therapist Assistant (PTA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 14th, 2020 |
| Last updated | May 14th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114549920 | NPPES |
| Oklahoma | Other | G082973974 | DRIVERS LICENSE |
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