Provider Demographics
NPI:1386842490
Name:GAMBALA, CECILIA TOLO (MD)
Entity type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:TOLO
Last Name:GAMBALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVENUE
Mailing Address - Street 2:SL-11
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112
Mailing Address - Country:US
Mailing Address - Phone:504-988-5216
Mailing Address - Fax:504-988-1846
Practice Address - Street 1:1430 TULANE AVE
Practice Address - Street 2:SL-11
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-5217
Practice Address - Fax:504-988-1846
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.117815207V00000X
LAMD.204933207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology