Provider Demographics
NPI:1720239502
Name:ARCOS, GAYLA
Entity Type:Individual
Prefix:
First Name:GAYLA
Middle Name:
Last Name:ARCOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 S ARGONAUT ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-1825
Mailing Address - Country:US
Mailing Address - Phone:209-808-1732
Mailing Address - Fax:
Practice Address - Street 1:2025 W MARCH LN STE 5
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6417
Practice Address - Country:US
Practice Address - Phone:209-472-1542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other