| Warren Regh C. Gabrillo Iii M.d. Inc. | |
|
631 N 13th Ave A Upland CA 91786-4946 | |
| (909) 982-2088 | |
| (909) 982-2058 |
| Full Name | Warren Regh C. Gabrillo Iii M.d. Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 631 N 13th Ave, Upland, California |
| Authorized Official Name and Position | Warren Regh Camotes Gabrillo (PRESIDENT) |
| Authorized Official Contact | 9099822088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren Regh C. Gabrillo Iii M.d. Inc. 631 N 13th Ave A Upland CA 91786-4946 Ph: (909) 982-2088 | Warren Regh C. Gabrillo Iii M.d. Inc. 631 N 13th Ave A Upland CA 91786-4946 Ph: (909) 982-2088 |
| NPI Number | 1962622803 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 02/03/2010 |
| Medicare PECOS PAC ID | 6507948536 |
|---|---|
| Medicare Enrollment ID | O20080130000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962622803 | NPI | - | NPPES |
| A517941 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A51794 (California) | Primary |
| Provider Name | Warren Gabrillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982689295 PECOS PAC ID: 2668437088 Enrollment ID: I20080130000388 |
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