Provider Demographics
NPI:1366632135
Name:B.SHEBA GABRAIL, M.D. INC.
Entity Type:Organization
Organization Name:B.SHEBA GABRAIL, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEBA
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-453-9700
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE # 906
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-453-9700
Mailing Address - Fax:949-453-9144
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE # 906
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-453-9700
Practice Address - Fax:949-453-9144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44848174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD83159Medicare UPIN