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General NPI Number Information
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NPI Number | 1588842348
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Entity Type | Organization
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Legal Business Name | MARISSA V GACOTE
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 32270 ALVARADO BLVD
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City | UNION CITY
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State | CA
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Zip | 94587-4004
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Country | US
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Telephone | 510-487-1198
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Fax | 510-487-1273
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Provider Business Mailing Address
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Address Line | 32270 ALVARADO BLVD
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City | UNION CITY
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State | CA
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Zip | 94587-4004
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Country | US
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Telephone | 510-487-1198
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Fax | 510-487-1273
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARISSA V. GACOTE
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Credential |
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Telephone | 510-487-1198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A84872
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License Number State | CA
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