Provider Demographics
NPI:1881601177
Name:HALPERIN, GABRIEL J (DPM)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:J
Last Name:HALPERIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2899
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91778-2899
Mailing Address - Country:US
Mailing Address - Phone:323-262-4146
Mailing Address - Fax:323-264-7778
Practice Address - Street 1:3612 1/2 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90063-2326
Practice Address - Country:US
Practice Address - Phone:323-262-4146
Practice Address - Fax:232-264-7778
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2246213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E24460Medicaid
CAWE2446AMedicare PIN
CAT11332Medicare UPIN