Provider Demographics
NPI:1821028283
Name:GABBAY, ROBERT J (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:GABBAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3775 BRICKWAY BLVD.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-8272
Mailing Address - Country:US
Mailing Address - Phone:707-535-6271
Mailing Address - Fax:707-526-5633
Practice Address - Street 1:3775 BRICKWAY BLVD.
Practice Address - Street 2:SUITE 110
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-8272
Practice Address - Country:US
Practice Address - Phone:707-535-6271
Practice Address - Fax:707-526-5633
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2012-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A6451207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G02831Medicare UPIN