Healthcare Provider Details

I. General information

NPI: 1124043138
Provider Name (Legal Business Name): NILOUFAR GABBAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S SPALDING DR STE 305
BEVERLY HILLS CA
90212-1836
US

IV. Provider business mailing address

24711 VIA PRADERA
CALABASAS CA
91302-1470
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-5888
  • Fax: 510-879-9100
Mailing address:
  • Phone: 818-489-7207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA17461
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberPA17461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: