MEDICARE: MS. NILOUFAR GABBAY PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	PA17461	CA
2	363A00000X	Physician Assistant	PA17461	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124043138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NILOUFAR GABBAY PA-C

Provider Business Mailing Address
First Line	:	24711 VIA PRADERA
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1470
Country	:	US
Telephone Number	:	818-489-7207
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 S SPALDING DR STE 305
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-1836
Country	:	US
Telephone Number	:	310-829-5888
Fax Number	:	510-879-9100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	11/11/2025

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