MEDICARE: DAVID BRIAN GEBROE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	8326	CA

General Provider Information

NPI Number	:	1023737905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BRIAN GEBROE

Provider Business Mailing Address
First Line	:	3439 GUNDRY AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-4819
Country	:	US
Telephone Number	:	323-365-0121
Fax Number	:

Provider Business Practice Location Address
First Line	:	4206 WOODRUFF AVE
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90713-3143
Country	:	US
Telephone Number	:	562-303-1436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	08/24/2022

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