Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A124995 | CA |
NPI | 1336465111 |
---|---|
Provider Name | Dr. Katherine Gabon Cadacio |
First Address | Stockton, CA 95210-3377 |
Second Address | Stockton, CA 95210-3377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 11/02/2022 |