Provider Demographics
NPI:1629086798
Name:GILBERT VARELA, M.D INC.
Entity Type:Organization
Organization Name:GILBERT VARELA, M.D INC.
Other - Org Name:ALLLIANCE HEALTH SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDEN & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:VARELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-724-6910
Mailing Address - Street 1:5233 E BEVERLY BLVD.
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-2020
Mailing Address - Country:US
Mailing Address - Phone:323-724-6910
Mailing Address - Fax:323-724-6915
Practice Address - Street 1:5233 E BEVERLY BLVD.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-2020
Practice Address - Country:US
Practice Address - Phone:323-724-6910
Practice Address - Fax:323-724-6915
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GILBERT VARELA M.D, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17179Medicare PIN