MEDICARE: ISRAEL MEIR GABAIE NURSE PRACTITIONER

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	363LF0000X	Family Nurse Practitioner	RN4708485	CA

General Provider Information

NPI Number	:	1669066148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISRAEL MEIR GABAIE NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	4567 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019
Country	:	US
Telephone Number	:	765-273-8483
Fax Number	:	323-375-3902

Provider Business Practice Location Address
First Line	:	4567 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019
Country	:	US
Telephone Number	:	765-273-8483
Fax Number	:	323-375-3902

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

Provider Enumeration Date	:	02/24/2021
Last Update Date	:	02/18/2026

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