Provider Demographics
NPI:1053457598
Name:ERWIN PETER GABOR,M.D. A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ERWIN PETER GABOR,M.D. A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:GABOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-432-8900
Mailing Address - Street 1:9663 SANTA MONICA BLVD
Mailing Address - Street 2:#792
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4303
Mailing Address - Country:US
Mailing Address - Phone:310-432-8900
Mailing Address - Fax:310-432-8901
Practice Address - Street 1:8900 WILSHIRE BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1958
Practice Address - Country:US
Practice Address - Phone:310-432-8900
Practice Address - Fax:310-432-8901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21520207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A215200Medicaid
CAB49928Medicare UPIN
CAA21520Medicare ID - Type Unspecified