| Gabriel Medical Center Inc | |
|
4146 E Olympic Blvd Unit B Los Angeles CA 90023-3347 | |
| (323) 262-9948 | |
| (562) 943-7518 |
| Full Name | Gabriel Medical Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4146 E Olympic Blvd, Los Angeles, California |
| Authorized Official Name and Position | Shura A Moreno (DIRECTOR) |
| Authorized Official Contact | 3232629948 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gabriel Medical Center Inc 4146 E Olympic Blvd Unit B Los Angeles CA 90023-3347 Ph: (323) 262-9948 | Gabriel Medical Center Inc 4146 E Olympic Blvd Unit B Los Angeles CA 90023-3347 Ph: (323) 262-9948 |
| NPI Number | 1598129652 |
|---|---|
| Provider Enumeration Date | 04/05/2016 |
| Last Update Date | 10/16/2018 |
| Medicare PECOS PAC ID | 9638467657 |
|---|---|
| Medicare Enrollment ID | O20161006002062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598129652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A78052 (California) | Primary |
| Provider Name | Shura A Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174542716 PECOS PAC ID: 2668362450 Enrollment ID: I20040316001333 |
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