Provider Demographics
NPI:1093512816
Name:GAMIZ, GUMERCINDO ISRAEL
Entity type:Individual
Prefix:
First Name:GUMERCINDO
Middle Name:ISRAEL
Last Name:GAMIZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9224 ESPADA AVE
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-6408
Mailing Address - Country:US
Mailing Address - Phone:424-270-4615
Mailing Address - Fax:
Practice Address - Street 1:9224 ESPADA AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-6408
Practice Address - Country:US
Practice Address - Phone:424-270-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA97549225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist