Provider Demographics
NPI:1831923812
Name:DUFORT, GABRIELLE ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:ANNE
Last Name:DUFORT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:501 FOREST AVE APT 1004
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2615
Mailing Address - Country:US
Mailing Address - Phone:514-652-5420
Mailing Address - Fax:
Practice Address - Street 1:213 QUARRY RD FL 4MC5979
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1416
Practice Address - Country:US
Practice Address - Phone:514-652-5420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1987802084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine