Provider Demographics
NPI:1508842741
Name:CARINO-GATEB, ZOSIMA B (MD)
Entity Type:Individual
Prefix:DR
First Name:ZOSIMA
Middle Name:B
Last Name:CARINO-GATEB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:81833 DOCTOR CARREON BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5590
Mailing Address - Country:US
Mailing Address - Phone:760-775-7763
Mailing Address - Fax:760-775-9953
Practice Address - Street 1:81833 DOCTOR CARREON BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5590
Practice Address - Country:US
Practice Address - Phone:760-775-7763
Practice Address - Fax:760-775-9953
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA458572080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A458571Medicaid
CA10944448OtherCAQH PROVIDER ID