Healthcare Provider Details

I. General information

NPI: 1316170996
Provider Name (Legal Business Name): GABRIELLE BELINDA DAVIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2009
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 NumberA108227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: