Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G69726 | CA |
N | 208600000X | Surgeon | G69726 | CA |
Y | 2086S0129X | Vascular Surgeon | G69726 | CA |
NPI | 1164453320 |
---|---|
Provider Name | Dr. Gabriel G. Carabello |
First Address | Glendale, CA 91208-3023 |
Second Address | Los Angeles, CA 90033-2424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 05/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G697260 | (05) | CA |
G52810 | (02) | CA |