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Gabriela Wicaksono, MD
Student in an Organized Health Care Education/Training Program in Orange, California
NPI 1538928080

Gabriela Wicaksono is a Student in an Organized Health Care Education/Training Program based in Orange, CA. Gabriela Wicaksono practices in Orange, CA and has the professional credentials of MD. The NPI Number for Gabriela Wicaksono is 1538928080 and holds a License No. (California).

The current practice location address for Gabriela Wicaksono is 505 S Main St Ste 525, Orange, CA and can be reached out via phone at 714-509-8547.

Location: 505 S Main St Ste 525, Orange, CA, 92868-4553
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538928080
Provider Name
Gabriela Wicaksono
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
505 S Main St Ste 525, Orange, CA, 92868-4553
Phone Number
714-509-8547
Fax Number
Provider Enumeration Date
03/18/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
505 S Main St Ste 525
City
Orange
State
California
Zip
92868-4553
Phone Number
714-509-8547
Fax Number
person
Provider Business Mailing Address Details
Address
505 S Main St Ste 525
City
Orange
State
California
Zip
92868-4553
Phone Number
714-509-8547
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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