Provider Demographics
NPI:1356484091
Name:AFSHIN ELI GABAYAN, M.D. INC.
Entity Type:Organization
Organization Name:AFSHIN ELI GABAYAN, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AFSHIN
Authorized Official - Middle Name:ELI
Authorized Official - Last Name:GABAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-652-2822
Mailing Address - Street 1:8700 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1804
Mailing Address - Country:US
Mailing Address - Phone:310-652-2822
Mailing Address - Fax:310-652-6018
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-652-2822
Practice Address - Fax:310-652-6018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A556130Medicaid
CAA55613Medicare ID - Type Unspecified
CAH24413Medicare UPIN