Healthcare Provider Details
I. General information
NPI: 1285469346
Provider Name (Legal Business Name): GABBI HEALTH MEDICAL GROUP OF CALIFORNIA, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/06/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
909 MONTGOMERY ST # 4F
SAN FRANCISCO CA
94133-4618
US
IV. Provider business mailing address
10350 N VANCOUVER WAY # 1067
PORTLAND OR
97217-7530
US
V. Phone/Fax
- Phone: 503-482-8374
- Fax:
- Phone: 805-286-7235
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMANDA
GRITZFELD
Title or Position: OPERATIONS
Credential:
Phone: 503-482-8374