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General NPI Number Information
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NPI Number | 1104118637
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Entity Type | Individual
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Provider Name | MARY SUSAN GABLE MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 529 GROTH CT
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9424
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Country | US
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Telephone | 408-309-6370
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Fax |
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Provider Business Mailing Address
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Address Line | 21206 SARAHILLS DR
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City | SARATOGA
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State | CA
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Zip | 95070-4869
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Country | US
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Telephone | 408-867-0195
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Fax | 408-877-1701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A105881
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A105881
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License Number State | CA
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