Provider Demographics
NPI:1124060827
Name:FABELLA, GABRIEL T (MD)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:T
Last Name:FABELLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10737 CAMINO RUIZ
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2359
Mailing Address - Country:US
Mailing Address - Phone:858-695-1262
Mailing Address - Fax:858-695-2132
Practice Address - Street 1:10737 CAMINO RUIZ
Practice Address - Street 2:SUITE 115
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-2359
Practice Address - Country:US
Practice Address - Phone:858-695-1262
Practice Address - Fax:858-695-2132
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2011-03-09
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Provider Licenses
StateLicense IDTaxonomies
CAA48087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F09020Medicare UPIN