Provider Demographics
NPI:1275504466
Name:GABLE, PRESTON S (MD)
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:S
Last Name:GABLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:NMCSD, ATTN: MEDICAL STAFF SERVICES
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-218-7490
Mailing Address - Fax:619-532-9196
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:NMCSD, ATTN: MEDICAL STAFF SERVICES
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-218-7490
Practice Address - Fax:619-532-9196
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2024-03-11
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Provider Licenses
StateLicense IDTaxonomies
CAG73414207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD0000Medicare UPIN