Provider Demographics
NPI:1962036525
Name:SMITH, GABRIEL ERNEST (MASTER OF SCIENCE PA)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:ERNEST
Last Name:SMITH
Suffix:
Gender:M
Credentials:MASTER OF SCIENCE PA
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Mailing Address - Street 1:4541 FALCON AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-1814
Mailing Address - Country:US
Mailing Address - Phone:562-370-7789
Mailing Address - Fax:
Practice Address - Street 1:4541 FALCON AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-1814
Practice Address - Country:US
Practice Address - Phone:562-370-7789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-22
Last Update Date:2020-02-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant