Provider Demographics
NPI:1588193213
Name:DAVILA, GABRIELA (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:DAVILA
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 CLEVELAND AVE APT D310
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3368
Mailing Address - Country:US
Mailing Address - Phone:480-628-0483
Mailing Address - Fax:
Practice Address - Street 1:4901 MORENA BLVD STE 209A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3571
Practice Address - Country:US
Practice Address - Phone:858-933-6163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17236171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist