Requeijo-Gamboa Epc Aco LLC

NPI #1700460938 in Carson City, Nevada

Provider Information

NPI Number: 1700460938
Entity Type: Organization
Organization Name: Requeijo-Gamboa Epc Aco LLC
Primary Specialty: Internal Medicine
Enumeration Date: May 12, 2021
Last Updated: May 12, 2021

Practice Location

Address: 1001 MOUNTAIN ST
City: Carson City
State: Nevada
ZIP Code: 89703-3848
Phone: (737) 226-6700

Authorized Official

Name: ANTONIO GAMBOA, MD
Title: OWNER
Phone: (737) 226-6700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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