Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | A45960 | CA |
NPI | 1063419604 |
---|---|
Provider Name | Dr. Gabriel Carabulea |
First Address | North Tustin, CA 92705-2427 |
Second Address | San Clemente, CA 92673-2859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 25/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F31761 | (02) |