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NPI Code Detail

MEDICARE: JOANNE KARLA ELLORIN GABOT-HEYMAN D.D.S.

MEDICARE: JOANNE KARLA ELLORIN GABOT-HEYMAN D.D.S.
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
1122300000XDentist57605CA

General Provider Information

NPI Number : 1942447644
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNE KARLA ELLORIN GABOT-HEYMAN D.D.S.
Provider Business Mailing Address
First Line : 26 ELDERWOOD
Second Line :
City : ALISO VIEJO
State : CA
Zip : 92656-2114
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2144 S BRISTOL ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-5123
Country : US
Telephone Number : 714-784-5779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2009
Last Update Date : 01/22/2015

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