Provider Demographics
NPI:1386612109
Name:SOTO, GABRIEL E (MD)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:E
Last Name:SOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:105 CATHERINE LN
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5705
Mailing Address - Country:US
Mailing Address - Phone:530-273-2525
Mailing Address - Fax:530-273-4777
Practice Address - Street 1:105 CATHERINE LN
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5705
Practice Address - Country:US
Practice Address - Phone:530-273-2525
Practice Address - Fax:530-273-4777
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA74943207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH98809Medicare UPIN
CAZZZ03314ZMedicare PIN