MEDICARE: GILBERT VARELA, M.D INC.

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	302R00000X	Health Maintenance Organization		CA

General Provider Information

NPI Number	:	1629086798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILBERT VARELA, M.D INC.

Provider Business Mailing Address
First Line	:	5233 E BEVERLY BLVD.
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-2020
Country	:	US
Telephone Number	:	323-724-6910
Fax Number	:	323-724-6915

Provider Business Practice Location Address
First Line	:	5233 E BEVERLY BLVD.
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-2020
Country	:	US
Telephone Number	:	323-724-6910
Fax Number	:	323-724-6915

Authorized Official
Title or Position	:	PRESIDEN & CEO
Name	:	DR. GILBERT RANDALL VARELA
Credential	:	M.D
Telephone Number	:	323-724-6910

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/21/2022

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