Provider Demographics
NPI:1295077873
Name:GABOR, DOMINICK (MPT)
Entity type:Individual
Prefix:MR
First Name:DOMINICK
Middle Name:
Last Name:GABOR
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 DIABLO RD
Mailing Address - Street 2:STE. 201
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-3461
Mailing Address - Country:US
Mailing Address - Phone:925-552-5787
Mailing Address - Fax:925-552-6173
Practice Address - Street 1:380 DIABLO RD
Practice Address - Street 2:STE. 201
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3461
Practice Address - Country:US
Practice Address - Phone:925-552-5787
Practice Address - Fax:925-552-6173
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA399372251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic