Doctor Name: | DR. CHARLES CLARK GABBERT |
NPI Number: | 1750587945 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | |
Business Practice Address: | 1595 Soquel Drive Suite 400 Santa Cruz, CA - 950651724 |
Business Phone Number: | 8314751111 |
Business Fax Number: | 8314765020 |
Mailing Address: | 1595 Soquel Drive, Suite 400 SANTA CRUZ |
State: | CA |
Postal Code: | 950651724 |
Phone Number: | 8314751111 |
Fax Number: | 8314765020 |
NPI Enumeration Date: | 06/25/2007 |
NPI Last Update Date: | 08/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |