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DR. SUSAN REBECCA GAMBLE M.D.
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1790950079
Individual Registrant:DR. SUSAN REBECCA GAMBLE M.D.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
10 WOODLAND RD SAINT HELENA, CA 94574-9554 US
Tel: 707-963-2002 Fax: 707-963-2003
Tel: 707-963-2002 Fax: 707-963-2003
Contact information for business:
10 WOODLAND RD SAINT HELENA, CA 94574-9554 US
Tel: 707-963-2002 Fax: --
Tel: 707-963-2002 Fax: --
Registration Information:
NPI: 1790950079
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | FL | ME 109612 |
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | CA | A123317 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| PENDING | FL | 05 | |
| BCBS | 14E2G | FL | 01 |
