Provider Demographics
NPI:1336194695
Name:ALARCON, GABRIEL (DO)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:ALARCON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17014 W BELL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2479
Mailing Address - Country:US
Mailing Address - Phone:623-866-4484
Mailing Address - Fax:844-327-6864
Practice Address - Street 1:17014 W BELL RD STE 100
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2479
Practice Address - Country:US
Practice Address - Phone:623-866-4484
Practice Address - Fax:844-327-6864
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-203966207Q00000X
CA20A15269207Q00000X
AZ010166207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5997104OtherGHI PPO
040921000033OtherFIDELIS
5216A3OtherBC/BS
10002410OtherCDPHP
239631OtherWELLCARE
P00173333OtherRAILROAD MEDICARE
000401482004OtherBSNENY
NY01832966Medicaid
988096OtherMVP
1389116OtherUNITED HEALTH CARE
72601OtherGHI HMO
5997104OtherGHI PPO
000401482004OtherBSNENY
P00173333OtherRAILROAD MEDICARE
NY01832966Medicaid
GAP00173333Medicare PIN