Provider Demographics
NPI:1144201138
Name:GAMBOL, PATRICIA J (APNG)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:J
Last Name:GAMBOL
Suffix:
Gender:F
Credentials:APNG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 NORTHWOOD RD
Mailing Address - Street 2:APT 272A
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-3492
Mailing Address - Country:US
Mailing Address - Phone:562-342-9356
Mailing Address - Fax:
Practice Address - Street 1:701 E 28TH ST
Practice Address - Street 2:SUITE 412
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2759
Practice Address - Country:US
Practice Address - Phone:562-933-7874
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNS2042364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist