MEDICARE: GBAMA MBAYO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WM0705X	Medical-Surgical Registered Nurse	95072066	CA

General Provider Information

NPI Number	:	1265192876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GBAMA MBAYO

Provider Business Mailing Address
First Line	:	5880 3RD ST APT 437
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94124-3172
Country	:	US
Telephone Number	:	518-866-3283
Fax Number	:

Provider Business Practice Location Address
First Line	:	5880 3RD ST APT 437
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94124-3172
Country	:	US
Telephone Number	:	518-866-3283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2021
Last Update Date	:	12/22/2021

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Directions to “ GBAMA MBAYO ” Practice Location

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