MR. JOSE L GAMBOA JR. (NPI# 1114549920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114549920 |
Entity Type | Individual |
Full Name | MR. JOSE L GAMBOA JR. |
Credential | PTA |
Practice Address |
9700 Mashburn Blvd Oklahoma City OK 73162-5509 |
Mailing Address |
9017 N University Ave Apt 14209 Oklahoma City OK 73114-4312 |
Practice Telephone | 4057212466 |
Mailing Telephone | 9183201205 |
Enumeration Date | 2020-05-14 |
Last Update Date | 2020-05-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
2694 | OK | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | DRIVERS LICENSE | G082973974 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326325176 | Jose Antonio Gamboa | Technician, Other | 702 N Mccoll Rd, Mcallen, TX 78501-9337 | 2011-11-08 |
1275615718 | Jose Gamboa | Psychiatry & Neurology | 1020 S Anaheim Blvd Ste 214, Anaheim, CA 92805-5808 | 2006-10-20 |
Street Address |
9700 MASHBURN BLVD |
City | OKLAHOMA CITY |
State | OK |
Zip Code | 73162-5509 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447253240 | Baptist Village Retirement Communities of Oklahoma Inc | Skilled Nursing Facility | 9700 Mashburn Blvd, Oklahoma City, OK 73162-5509 | 2005-05-24 |
1659916336 | Colleen Barnett | Dietitian, Registered | 9700 Mashburn Blvd, Oklahoma City, OK 73162-5509 | 2019-11-17 |
1528475837 | Alison Boyd | Nurse Practitioner | 9700 Mashburn Blvd, Oklahoma City, OK 73162-5509 | 2014-07-18 |
1053369090 | Baptist Village Retirement Communities of Ok, Inc | Home Health | 9700 Mashburn Blvd, Oklahoma City, OK 73162-5509 | 2006-05-04 |
1710945613 | Baptist Village Retirement Communities of Oklahoma, Inc. | Home Health | 9700 Mashburn Blvd, Oklahoma City, OK 73162-5509 | 2006-05-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114493319 | Anthony Haislip | Peer Specialist | 6904 Briar Creek Dr., Oklahoma City, OK 73162 | 2018-10-16 |
1760973705 | Lars Pederson | Peer Specialist | 7308 Nw 114th St, Oklahoma City, OK 73162 | 2018-05-25 |
1770026841 | Cory Chambers | Dentist | 12321 N. Council Rd, Oklahoma City, OK 73162 | 2016-11-22 |
1487109062 | K. Williams | Case Manager/Care Coordinator | 10400 North Council Road, Oklahoma City, OK 73162 | 2016-08-24 |
1932537669 | Al Dowell | Case Manager/Care Coordinator | 8849 Nw 121st St., Oklahoma City, OK 73162 | 2013-10-15 |
1508106378 | Wilvia Wong-plum | Counselor | 7309 N.w. 107th St., Oklahoma City, OK 73162 | 2013-02-15 |
1386912301 | Delores Parker | Counselor | 11916 Silvermoon Drive, Oklahoma City, OK 73162 | 2011-12-05 |
1518241744 | Victor Njoh | Pharmacist | 7101 West Hefner Rd, Oklahoma City, OK 73162 | 2011-10-06 |
1841500113 | Kimmi Jo Stanley | Speech-Language Pathologist | 9400 St. Ann's Home, Oklahoma City, OK 73162 | 2010-10-20 |
1548493091 | Glen Knight Wallace | Counselor | 7932 Nicholson, Okalhoma City, OK 73162 | 2009-09-01 |
Find all providers in zip 73162 |
Taxonomy Code | 2251G0304X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Physical Therapist |
Specialization | Geriatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306118518 | Melanie Susan Thomas | Physical Therapist | 14901 N Pennsylvania Ave, Oklahoma City, OK 73134-6069 | 2012-02-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
1588039937 | Judy Maupin | Physical Therapist | 801 Nw 145th Cir, Edmond, OK 73013-1876 | 2015-12-10 |
1326455486 | Home Mods By Therapists, LLC | Physical Therapist | 3424 Mount Washington Rd, Ardmore, OK 73401-9311 | 2014-07-21 |
1568883155 | Hannah Hargis | Physical Therapist | 5115 E 51st St, Tulsa, OK 74135-7430 | 2013-12-26 |
1033466305 | Judy Howard | Physical Therapist | 429 Gold Fields Trl, Edmond, OK 73003-2078 | 2012-08-06 |
1003394636 | Karen Rae Smith | Physical Therapist | 6800 S Granite Ave, Tulsa, OK 74136-7039 | 2018-08-06 |
1336532639 | Kendra Stanaland | Physical Therapist | 1165 Brenner Rd, Sapulpa, OK 74066-6141 | 2015-03-11 |
1023441227 | Therapy Solutions of Oklahoma Inc. | Physical Therapist | 8303 E 81st St, Suite E, Tulsa, OK 74133-8093 | 2013-08-12 |
1164786711 | Tram Bich Cao | Physical Therapist | 2111 Riverwalk Dr, Moore, OK 73160-2700 | 2012-06-28 |
City | OKLAHOMA CITY |
Zip Code | 73162 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.