Healthcare Provider Details

I. General information

NPI: 1053457598
Provider Name (Legal Business Name): ERWIN PETER GABOR,M.D. A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 WILSHIRE BLVD 2ND FLOOR
BEVERLY HILLS CA
90211-1958
US

IV. Provider business mailing address

9663 SANTA MONICA BLVD #792
BEVERLY HILLS CA
90210-4303
US

V. Phone/Fax

Practice location:
  • Phone: 310-432-8900
  • Fax: 310-432-8901
Mailing address:
  • Phone: 310-432-8900
  • Fax: 310-432-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA21520
License Number StateCA

VIII. Authorized Official

Name: ERWIN PETER GABOR
Title or Position: OWNER
Credential: M.D.
Phone: 310-432-8900