Gambrell, Larry Kyle
Gambrell, Larry Kyle is an sole proprietor health care provider with primary practice located at 6880 Palm Avenue , Sebastopol CA 95472. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, which is considered as his primary health care specialty. Gambrell, Larry Kyle can be contacted via phone (707) 823-7628.Contact Information
Primary practice address
6880 Palm Avenue
Sebastopol CA 95472
Phone: (707) 823-7628
Fax: (707) 823-1521
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery | 207YX0905X | 20A9837 | California |
Profile Details
| NPI number | 1275621963 |
|---|---|
| LBN Legal business name | Gambrell, Larry Kyle |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Mar 3rd, 2015 - about 9 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 | 1275621963 | NPPES |
| California | Other | CA107813 | MEDICARE |
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