Most Relevant Information
Provider Data
| NPI Number: | 1003569955 |
| Provider Name: | GANIECE GAUBATZ |
| Entity Type: | Individual |
| Taxonomy Code: | 156FX1800X |
| Specialty: | Technician/Technologist |
| License Number: | 42517 |
Most Important Dates
| Enumeration Date: | 02/01/2022 |
| Last Updated: | 02/01/2022 |
Provider Practice Location
3981 IRVINE BLVD
IRVINE
CA
926022400
Practice Location Phone/Fax
| Phone: | 7143381603 |
| Fax: | 7143684722 |
Provider Mailing Location
1 CVS DRIVE
MAIL STOP #3005
WOONSOCKET
RI
02895
Provider Mailing Phone/Fax
| Phone: | 4017702286 |
| Fax: | 4012694731 |