Provider Demographics
NPI:1407488240
Name:TOTTON, GABRIELLE ELIZABETH
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ELIZABETH
Last Name:TOTTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W DATE ST APT 408
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2695
Mailing Address - Country:US
Mailing Address - Phone:248-872-4749
Mailing Address - Fax:
Practice Address - Street 1:13010 POWAY RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4520
Practice Address - Country:US
Practice Address - Phone:858-218-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601010155363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant