Provider Demographics
NPI:1811292022
Name:GEETHA V. GABBITA, M.D., INC.
Entity type:Organization
Organization Name:GEETHA V. GABBITA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETHA
Authorized Official - Middle Name:V
Authorized Official - Last Name:GABBITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-698-8263
Mailing Address - Street 1:14568 WHITTIER BLVD
Mailing Address - Street 2:WHITTIER
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2129
Mailing Address - Country:US
Mailing Address - Phone:562-698-8263
Mailing Address - Fax:562-698-1001
Practice Address - Street 1:14568 WHITTIER BLVD
Practice Address - Street 2:WHITTIER
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2129
Practice Address - Country:US
Practice Address - Phone:562-698-8263
Practice Address - Fax:562-698-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43392208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A433920Medicaid
CAA43392Medicare PIN
CAE01676Medicare UPIN