MEDICARE: ANGELICA MARIE GABRIEL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH66533	CA
2	183500000X	Pharmacist	18103	NV
3	183500000X	Pharmacist	PH0167	GU

General Provider Information

NPI Number	:	1285903278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA MARIE GABRIEL PHARMD

Provider Business Mailing Address
First Line	:	925 ORANGE AVE
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-2609
Country	:	US
Telephone Number	:	619-435-6354
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 ORANGE AVE
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-2609
Country	:	US
Telephone Number	:	619-435-6354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2011
Last Update Date	:	02/28/2014

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