Healthcare Provider Details

I. General information

NPI: 1841644366
Provider Name (Legal Business Name): JOUBIN S. GABBAY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9663 SANTA MONICA BLVD # 154
BEVERLY HILLS CA
90210-4303
US

IV. Provider business mailing address

9663 SANTA MONICA BLVD # 154
BEVERLY HILLS CA
90210-4303
US

V. Phone/Fax

Practice location:
  • Phone: 310-367-2573
  • Fax: 877-239-0994
Mailing address:
  • Phone: 310-367-2573
  • Fax: 877-239-0994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA84648
License Number StateCA

VIII. Authorized Official

Name: OJEAN SINANIAN
Title or Position: BILLING MANAGER
Credential:
Phone: 310-367-2573