Individual provider Active NPI

Gabriel T Fabella, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1124060827
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A48087 Issued in CA
Practice address
10737 Camino Ruiz
Suite 115
San Diego, CA 92126-2359
Phone
(858) 695-1262
Fax
(858) 695-2132
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A48087 CA Primary

Addresses

Primary practice location

10737 Camino Ruiz
Suite 115
San Diego, CA 92126-2359

Mailing address

10737 Camino Ruiz
Suite 115
San Diego, CA 92126-2359
Phone (858) 695-1262

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
I20040723000731 CA Practitioner - Internal Medicine 3274519046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10737 Camino Ruiz
Suite 115
San Diego, CA 92126-2359

10737 Camino Ruiz
Suite 115
San Diego, CA 92126-2361
Phone (858) 695-1262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48087CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel T Fabella MD Inc Internal Medicine CurrentSince Jul 1, 2004 Accepting new patients
Daviess County Hospital Past Accepting new patients
Daviess County Hospital Past Accepting new patients

Locations

9116 Foothill Blvd
Ste 102
Rch Cucamonga, CA 91730
Phone (812) 486-9106

10737 Camino Ruiz
San Diego, CA 92126
Phone (858) 536-7799

10737 Camino Ruiz
Ste 115
San Diego, CA 92126
Phone (858) 695-1262

Organizations & group practices 3

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1124060827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10737 CAMINO RUIZ",
            "address_2": "SUITE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262359",
            "telephone_number": "858-695-1262",
            "fax_number": "858-695-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10737 CAMINO RUIZ",
            "address_2": "SUITE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262359",
            "telephone_number": "858-695-1262",
            "fax_number": "858-695-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABELLA",
        "first_name": "GABRIEL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A48087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.