Provider Demographics
NPI:1023245016
Name:GIZAW, GABRIEL T (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:T
Last Name:GIZAW
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 357046
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92135-7046
Mailing Address - Country:US
Mailing Address - Phone:619-545-4263
Mailing Address - Fax:
Practice Address - Street 1:601 MCCAIN BLVD
Practice Address - Street 2:NMRTU NORTH ISLAND
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92135-7046
Practice Address - Country:US
Practice Address - Phone:619-545-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI55676-0202083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine