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General NPI Number Information
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NPI Number | 1053317230
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Entity Type | Individual
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Provider Name | JEFFREY G. GAMBLE D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 05/14/2018
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Provider Practice Location Address
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Address Line | 77564 COUNTRY CLUB DR STE 320
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City | PALM DESERT
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State | CA
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Zip | 92211
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Country | US
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Telephone | 760-610-1589
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Fax | 760-610-1633
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Provider Business Mailing Address
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Address Line | 81566 RANCHO SANTANA DR
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City | LA QUINTA
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State | CA
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Zip | 92253-9094
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Country | US
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Telephone | 760-610-1589
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Fax | 760-610-1633
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC17145
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License Number State | CA
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