Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 58049 | CA |
NPI | 1063880706 |
---|---|
Provider Name | Gipsi Cabrera |
First Address | Burbank, CA 91504-3750 |
Second Address | North Hills, CA 91343-2234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2015 |
Last Update Date | 11/09/2015 |