MEDICARE: GABY J. ABDO, D.O., A MEDICAL CORP.

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	207R00000X	Internal Medicine Physician	20A7216	CA

General Provider Information

NPI Number	:	1386911055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GABY J. ABDO, D.O., A MEDICAL CORP.

Provider Business Mailing Address
First Line	:	5546 ROSEMEAD BLVD
Second Line	:	SUITE 207
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-1845
Country	:	US
Telephone Number	:	626-433-7253
Fax Number	:	626-782-6263

Provider Business Practice Location Address
First Line	:	5546 ROSEMEAD BLVD
Second Line	:	SUITE 207
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-1845
Country	:	US
Telephone Number	:	626-433-7253
Fax Number	:	626-782-6263

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GABY JEAN ABDO
Credential	:	DO
Telephone Number	:	626-433-7253

Provider Enumeration Date	:	11/24/2011
Last Update Date	:	10/23/2012

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