Individual provider Active NPI

Gabriel Carabulea, M.D.

  • Hematology & Oncology Physician
  • San Clemente, CA
National Provider Identifier
1063419604
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A45960 Issued in CA
Practice address
665 Camino de Los Mares
Ste 208
San Clemente, CA 92673-2859
Phone
(714) 466-0787
Fax
(714) 417-9821
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A45960 CA Primary

Addresses

Primary practice location

665 Camino de Los Mares
Ste 208
San Clemente, CA 92673-2859

Mailing address

10721 Equestrian Dr
North Tustin, CA 92705-2427
Phone (714) 417-9821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051130000398 CA Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Medical Oncology 8325068703 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A45960CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel Carabulea, M.D., Inc. CurrentSince Jan 1, 2007 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

665 Camino de los Mares
Ste 208
San Clemente, CA 92673
Phone (714) 466-0787

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1063419604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 EQUESTRIAN DR",
            "city": "NORTH TUSTIN",
            "state": "CA",
            "postal_code": "927052427",
            "telephone_number": "714-417-9821",
            "fax_number": "714-417-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 CAMINO DE LOS MARES",
            "address_2": "STE 208",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732859",
            "telephone_number": "714-466-0787",
            "fax_number": "714-417-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABULEA",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A45960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.