Provider Demographics
NPI:1447449194
Name:PATRICIA GABRIEL DO ASSOCIATES LLC
Entity type:Organization
Organization Name:PATRICIA GABRIEL DO ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:928-726-9000
Mailing Address - Street 1:PO BOX 13003
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-3002
Mailing Address - Country:US
Mailing Address - Phone:928-726-9000
Mailing Address - Fax:928-726-7535
Practice Address - Street 1:1841 W 25TH ST
Practice Address - Street 2:STE B
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6910
Practice Address - Country:US
Practice Address - Phone:928-726-9000
Practice Address - Fax:928-726-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ29565Medicare PIN