Provider Demographics
NPI:1619194446
Name:GABRIEL J HALPERIN DPM INC
Entity Type:Organization
Organization Name:GABRIEL J HALPERIN DPM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALPERIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-264-6157
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-0629
Mailing Address - Country:US
Mailing Address - Phone:323-164-6157
Mailing Address - Fax:323-264-0099
Practice Address - Street 1:3616 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90063-2326
Practice Address - Country:US
Practice Address - Phone:323-164-6157
Practice Address - Fax:323-264-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGRE001640Medicaid
CA0866210001Medicare NSC
CAW17455Medicare UPIN
CAW11972Medicare PIN