Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | A154705 | CA |
NPI | 1063959153 |
---|---|
Provider Name | Gabriela Moriel |
First Address | Los Angeles, CA 90010-2814 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2017 |
Last Update Date | 10/06/2019 |