Healthcare Provider Details

I. General information

NPI: 1366623225
Provider Name (Legal Business Name): GABRIEEL M. GAORIYE MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W. ORANGE GROVE RD. #612
TUCSON AZ
85704-0000
US

IV. Provider business mailing address

2001 W. ORANGE GROVE RD. #612
TUCSON AZ
85704-0000
US

V. Phone/Fax

Practice location:
  • Phone: 520-297-9813
  • Fax: 520-297-0705
Mailing address:
  • Phone: 520-297-9813
  • Fax: 520-297-0705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number37313
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number37313
License Number StateAZ

VIII. Authorized Official

Name: DR. GABRIEEL MOSA GAORIYE
Title or Position: OWNER
Credential: M.D.
Phone: 520-297-9813