Provider Demographics
NPI:1750763736
Name:GABRIEL GABBAYPOUR, DDS, MD, INC
Entity type:Organization
Organization Name:GABRIEL GABBAYPOUR, DDS, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GABBAYPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:310-276-1155
Mailing Address - Street 1:465 N ROXBURY DR
Mailing Address - Street 2:SUITE 815
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4206
Mailing Address - Country:US
Mailing Address - Phone:310-276-1155
Mailing Address - Fax:310-276-1418
Practice Address - Street 1:465 N ROXBURY DR
Practice Address - Street 2:SUITE 815
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4206
Practice Address - Country:US
Practice Address - Phone:310-276-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43531261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1003910142OtherPERSONAL NPI