Provider Demographics
NPI:1518916881
Name:GABRIEL, ANTHONY E (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:E
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HAWAII STREET
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4814
Mailing Address - Country:US
Mailing Address - Phone:562-856-4501
Mailing Address - Fax:866-441-2153
Practice Address - Street 1:1191 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9609
Practice Address - Country:US
Practice Address - Phone:559-935-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG82095207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110180826OtherRAILROAD
CA00G820950Medicaid
CA00G820950Medicare ID - Type UnspecifiedMEDICARE
CA00G820950Medicaid