Provider Demographics
NPI:1386603314
Name:GABRIEL, CAROLYN CAFFREY (OD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:CAFFREY
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 E GREEN ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2401
Mailing Address - Country:US
Mailing Address - Phone:626-793-1483
Mailing Address - Fax:626-793-5449
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-793-1483
Practice Address - Fax:626-793-5449
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6442T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT70112Medicare UPIN