Healthcare Provider Details

I. General information

NPI: 1255626040
Provider Name (Legal Business Name): GABRIEL J BELSKY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 ALHAMBRA BLVD SUITE 330
SACRAMENTO CA
95816-5238
US

IV. Provider business mailing address

10470 OLD PLACERVILLE RD SUITE 100
SACRAMENTO CA
95827-2539
US

V. Phone/Fax

Practice location:
  • Phone: 916-731-7770
  • Fax: 916-731-7851
Mailing address:
  • Phone: 800-470-0071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A12557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: