| Gospha G, Campbell Md Inc | |
|
1850 S Waterman Ave # F San Bernardino CA 92408-2877 | |
| (909) 890-9393 | |
| (909) 890-9394 |
| Full Name | Gospha G, Campbell Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1850 S Waterman Ave # F, San Bernardino, California |
| Authorized Official Name and Position | Gospha G Campbell (PHYSICIAN) |
| Authorized Official Contact | 9098909393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gospha G, Campbell Md Inc 1850 S Waterman Ave, # F San Bernardino CA 92408-2464 Ph: (909) 890-9393 | Gospha G, Campbell Md Inc 1850 S Waterman Ave # F San Bernardino CA 92408-2877 Ph: (909) 890-9393 |
| NPI Number | 1215182803 |
|---|---|
| Provider Enumeration Date | 11/24/2008 |
| Last Update Date | 02/15/2012 |
| Medicare PECOS PAC ID | 5698829471 |
|---|---|
| Medicare Enrollment ID | O20090812000892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215182803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | A 102029 (California) | Primary |
| Provider Name | Gospha G Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306012935 PECOS PAC ID: 2062566847 Enrollment ID: I20090812000888 |
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