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Organization
NEUROLOGY PEDIATRIC NEUROLOGY
Active
Organization
NEUROLOGY PEDIATRIC NEUROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD GABRIEL (OWNER)
(310) 277-9533
Entity
Organization
Contact information
Practice address
2080 CENTURY PARK E, SUITE 203, LOS ANGELES, CA 90067-2001
(310) 277-9533
(310) 277-9285
Mailing address
2080 CENTURY PARK E, SUITE 203, LOS ANGELES, CA 90067-2001
(310) 277-9533
(310) 277-9285
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ54595Z
BLUE SHIELD
CA
Enumeration date
03/29/2007
Last updated
08/22/2020
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