Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2008-01775 | NC |
N | 207Q00000X | Family Doctor | 232725 | MA |
N | 207Q00000X | Family Doctor | A93276 | CA |
NPI | 1003006149 |
---|---|
Provider Name | Dr. Stephen H Gamboa |
First Address | Chapel Hill, NC 27599-0001 |
Second Address | Chapel Hill, NC 27599-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 15/12/2021 |