Healthcare Provider Details

I. General information

NPI: 1144383449
Provider Name (Legal Business Name): DR. PAUL N. GOBBO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 04/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S 48TH ST SUITE 605
LINCOLN NE
68506-1276
US

IV. Provider business mailing address

1500 S 48TH ST SUITE 605
LINCOLN NE
68506-1276
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-8560
  • Fax: 402-486-4953
Mailing address:
  • Phone: 402-483-8560
  • Fax: 402-486-4953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number18104
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18104
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: