Yonathan Gamboa

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Practice address

966 W Mariposa Ave
Stockton, CA 95204-3017

Phone

(209) 643-9420

NPI assigned

Dec 31, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1336736750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 W MARIPOSA AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043017",
            "telephone_number": "209-643-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 W MARIPOSA AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043017",
            "telephone_number": "209-643-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "YONATHAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macristina Recto Galvez, D.M.D.
• Rebecca Suzanne Galvez, P.T.
• Katelynn Galvin, M.S., CCC-SLP
• Janelle Gamble, LVN
• Arianna Alexarae Gamboa
• Giselle Monique Gamez
• Isabel Gamez
• Vanessa Gamez
• Esmeralda Jasmin Gamino
• Alejandra Gamon, DO

• Dental Clinic/Center in Stockton, CA
• Providers in Stockton, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.