Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | G48452 | CA |
NPI | 1487700738 |
---|---|
Provider Name | James Gibson Gamble |
First Address | Palo Alto, CA 94304-1607 |
Second Address | Palo Alto, CA 94304-1607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 18/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A51061 | (02) | CA |