Provider Demographics
NPI:1043245822
Name:PLASENCIA, GILBERT OSCAR (MD)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:OSCAR
Last Name:PLASENCIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2250 S MAIN ST
Mailing Address - Street 2:SUITE #201
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5302
Mailing Address - Country:US
Mailing Address - Phone:951-734-4880
Mailing Address - Fax:951-734-7963
Practice Address - Street 1:2250 S MAIN ST
Practice Address - Street 2:SUITE #201
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5302
Practice Address - Country:US
Practice Address - Phone:951-734-4880
Practice Address - Fax:951-734-7963
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG33034207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA45393Medicare UPIN
CA00G330340Medicare PIN