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NPI Code Detail

MEDICARE: DENISE GAMMAGE

MEDICARE: DENISE GAMMAGE
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
195-2633765OTHERCAMEDI-CAL

General Provider Information

NPI Number : 1518098128
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE GAMMAGE
Provider Business Mailing Address
First Line : 40507 PINNACLE WAY
Second Line :
City : PALMDALE
State : CA
Zip : 93551
Country : US
Telephone Number : 661-722-5474
Fax Number :
Provider Business Practice Location Address
First Line : 43520 DIVISION ST
Second Line :
City : LANCASTER
State : CA
Zip : 93535-4089
Country : US
Telephone Number : 661-272-4883
Fax Number : 661-272-1005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 08/28/2012

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Directions to “ DENISE GAMMAGE ” Practice Location

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