Provider Demographics
NPI:1336391960
Name:GABRIEL G. PAI, M.D. INC.
Entity Type:Organization
Organization Name:GABRIEL G. PAI, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:GARBIC
Authorized Official - Last Name:PAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-818-5718
Mailing Address - Street 1:10001 VENICE BLVD
Mailing Address - Street 2:UNIT 402
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-6493
Mailing Address - Country:US
Mailing Address - Phone:310-818-5718
Mailing Address - Fax:
Practice Address - Street 1:2103 MONTROSE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1546
Practice Address - Country:US
Practice Address - Phone:818-957-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86139207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty