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NPI Code Detail

MEDICARE: MR. GILBERT R VARELA M.D.

MEDICARE: MR. GILBERT R VARELA M.D.
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
1207Q00000XFamily Medicine PhysicianG74665CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110976197OTHERCACAQH
2970029OTHERCAQUALIFIED MED EVALUATOR

General Provider Information

NPI Number : 1396795985
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GILBERT R VARELA M.D.
Provider Business Mailing Address
First Line : 5233 E BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022
Country : US
Telephone Number : 323-724-6911
Fax Number : 323-724-6915
Provider Business Practice Location Address
First Line : 5232 E BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-2002
Country : US
Telephone Number : 323-724-6911
Fax Number : 323-724-6915
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 10/27/2016

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