Provider Demographics
NPI:1457602757
Name:GABOR KOVACS MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:GABOR KOVACS MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOVACS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-499-3085
Mailing Address - Street 1:31852 COAST HWY
Mailing Address - Street 2:STE 305
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-6764
Mailing Address - Country:US
Mailing Address - Phone:949-499-3085
Mailing Address - Fax:949-499-4095
Practice Address - Street 1:31852 COAST HWY
Practice Address - Street 2:STE 305
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6764
Practice Address - Country:US
Practice Address - Phone:949-499-3085
Practice Address - Fax:949-499-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34788207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW8372OtherMEDICARE ID
CAW8372OtherMEDICARE ID