Provider Demographics
NPI:1598072779
Name:GAMBOA, JOE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:
Last Name:GAMBOA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3333 SKYPARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5023
Mailing Address - Country:US
Mailing Address - Phone:310-257-7297
Mailing Address - Fax:310-539-1322
Practice Address - Street 1:23326 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3725
Practice Address - Country:US
Practice Address - Phone:310-257-7205
Practice Address - Fax:310-598-3119
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2015-10-28
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Provider Licenses
StateLicense IDTaxonomies
CAA119662207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine