Healthcare Provider Details

I. General information

NPI: 1275068033
Provider Name (Legal Business Name): GABRIEL HENRY CAMPION MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 ROSCOE BLVD
NORTHRIDGE CA
91325-4105
US

IV. Provider business mailing address

2355 WESTWOOD BLVD # 1228
LOS ANGELES CA
90064-2109
US

V. Phone/Fax

Practice location:
  • Phone: 818-885-8500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA158251
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: