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General NPI Number Information
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NPI Number | 1093274623
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Entity Type | Individual
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Provider Name | GABRIELLE THOMASON
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Gender | Female
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 9888 CARMEL MOUNTAIN RD STE J
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City | SAN DIEGO
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State | CA
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Zip | 92129-2807
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Country | US
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Telephone | 858-207-4481
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Fax | 858-216-8496
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Provider Business Mailing Address
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Address Line | 3070 MADISON ST
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City | CARLSBAD
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State | CA
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Zip | 92008-2310
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Country | US
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Telephone | 760-434-6100
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Fax | 760-434-4583
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 296373
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License Number State | CA
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