Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | A155356 | CA |
NPI | 1184971194 |
---|---|
Provider Name | Gabriel Gabarain |
First Address | Moreno Valley, CA 92552-7270 |
Second Address | Riverside, CA 92506-2858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2012 |
Last Update Date | 06/01/2021 |