Provider Demographics
NPI:1033772850
Name:GABRIELLE B DAVIS MD, INC
Entity Type:Organization
Organization Name:GABRIELLE B DAVIS MD, INC
Other - Org Name:GABRIELLE B. DAVIS, MD PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER- PLASTIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:BELINDA
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-614-5898
Mailing Address - Street 1:450 N ROXBURY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4218
Mailing Address - Country:US
Mailing Address - Phone:310-614-5898
Mailing Address - Fax:
Practice Address - Street 1:9400 BRIGHTON WAY STE 405
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4711
Practice Address - Country:US
Practice Address - Phone:310-614-5898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1316170996OtherNPI NUMBER OF OWNER OF S- CORP- SINGLE EMPLOYEE CURRENTLY
CA1316170996OtherNPI NUMBER OF OWNER