Healthcare Provider Details

I. General information

NPI: 1659674620
Provider Name (Legal Business Name): GABRIEL CHARLES KOSSOL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2010
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 CHURN CREEK RD STE F
REDDING CA
96002-0748
US

IV. Provider business mailing address

2070 CHURN CREEK RD STE F
REDDING CA
96002-0748
US

V. Phone/Fax

Practice location:
  • Phone: 530-768-1101
  • Fax:
Mailing address:
  • Phone: 530-768-1101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: