Individual
EPHRAIM MOLLA GABRIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MPH
Contact information
Practice address
16300 ROSCOE BLVD STE A1, VAN NUYS, CA 91406-1246
(818) 893-4426
(818) 894-7564
Mailing address
18862 DUKAS ST, PORTER RANCH, CA 91326-2133
(651) 233-0233
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
A114323
CA
2083X0100X
Occupational Medicine Physician
63777
GA
2083X0100X
Occupational Medicine Physician
Primary
A114323
CA
2083X0100X
Occupational Medicine Physician
ME108383
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63777
GEORGIA PHYSICIAN LICENSE
GA
01
—
A114323
CALIFORNIA PHYSICIAN LICENSE
CA
01
—
ME108383
FLORIDA PHYSICIAN LICENSE
FL
Enumeration date
09/03/2008
Last updated
03/30/2020
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