Provider Demographics
NPI:1023737905
Name:GEBROE, DAVID BRIAN
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRIAN
Last Name:GEBROE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3439 GUNDRY AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4819
Mailing Address - Country:US
Mailing Address - Phone:323-365-0121
Mailing Address - Fax:
Practice Address - Street 1:4206 WOODRUFF AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90713-3143
Practice Address - Country:US
Practice Address - Phone:562-303-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8326237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist