Healthcare Provider Details

I. General information

NPI: 1275504466
Provider Name (Legal Business Name): PRESTON S. GABLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR NMCSD, ATTN: MEDICAL STAFF SERVICES
SAN DIEGO CA
92134-1098
US

IV. Provider business mailing address

34800 BOB WILSON DR NMCSD, ATTN: MEDICAL STAFF SERVICES
SAN DIEGO CA
92134-1098
US

V. Phone/Fax

Practice location:
  • Phone: 619-218-7490
  • Fax: 619-532-9196
Mailing address:
  • Phone: 619-218-7490
  • Fax: 619-532-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG73414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: