Provider Demographics
NPI:1972727667
Name:SAN GABRIEL UNIFIED SCHOOL DISTRICT
Entity type:Organization
Organization Name:SAN GABRIEL UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:PAPPALARDO
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:626-451-5432
Mailing Address - Street 1:408 JUNIPERO SERRA DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1235
Mailing Address - Country:US
Mailing Address - Phone:626-451-5400
Mailing Address - Fax:626-451-5494
Practice Address - Street 1:102 E BROADWAY
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-4500
Practice Address - Country:US
Practice Address - Phone:626-292-2431
Practice Address - Fax:626-292-7424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS1975291Medicaid