Provider Demographics
NPI:1851588222
Name:BARRERA, GABRIEL (PA-C)
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:BARRERA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15421 E GALE AVE UNIT 92125
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91715-3896
Mailing Address - Country:US
Mailing Address - Phone:626-290-7055
Mailing Address - Fax:800-448-1194
Practice Address - Street 1:15421 E GALE AVE UNIT 92125
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91715-3896
Practice Address - Country:US
Practice Address - Phone:626-290-7055
Practice Address - Fax:800-448-1194
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19359363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant