Provider Demographics
NPI:1306875539
Name:FOO, GABRIEL KANMING (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:KANMING
Last Name:FOO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1408 GAZENIA CT
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6084
Mailing Address - Country:US
Mailing Address - Phone:805-278-9814
Mailing Address - Fax:805-278-9814
Practice Address - Street 1:117 W BUNNY AVE
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-2805
Practice Address - Country:US
Practice Address - Phone:805-739-3890
Practice Address - Fax:805-347-7697
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2008-02-19
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Provider Licenses
StateLicense IDTaxonomies
CAA82154207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A821540Medicaid
CA00A821540Medicaid
CAH28007Medicare UPIN