=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992093512
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GABRIELA DEL PILAR GARCIA NORES MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2011
-----------------------------------------------------
Last Update Date | 06/03/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1364 CLIFTON RD NE
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-778-7280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 550 PEACHTREET STREET - MOT 9TH FLOOR DEPARTMENT OF PLASTIC SURGERY
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30308-2247
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-686-4411
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 80797
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | 80797
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------