Dr. Larry Kyle Gambrell
Otolaryngology/Facial Plastic Surgery
6880 Palm Avenue
Sebastopol
, California 95472
Dr. Larry Kyle Gambrell
Otolaryngology/Facial Plastic Surgery
6880 Palm Avenue
Sebastopol
, California 95472
(707) 823-1521
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About
Features
Specialties
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- Dr. Larry Kyle Gambrell
- 6880 Palm Ave
- Sebastopol, CA
- Zip : 95472-4270
- Fax : (707) 823-1521
- Phone : (707) 823-7628
Second Address
- Dr. Larry Kyle Gambrell
- 6880 Palm Avenue
- Sebastopol, CA
- Zip : 95472
- Fax : (707) 823-1521
- Phone : (707) 823-7628
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 20A9837 | CA |
National Provider Identifier
| NPI | 1275621963 |
|---|---|
| Provider Name | Dr. Larry Kyle Gambrell |
| First Address | Sebastopol, CA 95472-4270 |
| Second Address | Sebastopol, CA 95472 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/10/2006 |
| Last Update Date | 03/03/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| CA107813 | MEDICARE (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.