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1538928080
GABRIELA WICAKSONO
ORANGE, CA
NPI
1538928080
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-18
Last Update Date
2024-03-18
Business Address
GABRIELA WICAKSONO MD
505 S MAIN ST STE 525
ORANGE, CA 92868-4553
Phone number: 714-509-8547
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Mailing Address
GABRIELA WICAKSONO MD
505 S MAIN ST STE 525
ORANGE, CA 92868-4553
Phone number: 714-509-8547
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