Healthcare Provider Details

I. General information

NPI: 1033772850
Provider Name (Legal Business Name): GABRIELLE B DAVIS MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 BRIGHTON WAY STE 405
BEVERLY HILLS CA
90210-4711
US

IV. Provider business mailing address

450 N ROXBURY DR STE 400
BEVERLY HILLS CA
90210-4218
US

V. Phone/Fax

Practice location:
  • Phone: 310-614-5898
  • Fax:
Mailing address:
  • Phone: 310-614-5898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GABRIELLE BELINDA DAVIS
Title or Position: OWNER- PLASTIC SURGEON
Credential: MD
Phone: 310-614-5898