Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E1486 | CA |
Y | 222Z00000X | Podiatrist | E1486 | CA |
NPI | 1033139928 |
---|---|
Provider Name | Michael F Gabhart |
First Address | Sacramento, CA 95827-2539 |
Second Address | Yuba City, CA 95991-5005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 18/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033139928 | (05) | CA |
AG4854813 | DEA (01) | CA |
P00770092 | RAILROAD MEDICARE (01) | |
T10973 | (02) |