| Gap Post-acute Care Services | |
|
11750 Wetherby Ln Los Angeles CA 90077-1348 | |
| (310) 597-9705 | |
| Not Available |
| Full Name | Gap Post-acute Care Services |
|---|---|
| Speciality | Family Medicine |
| Location | 11750 Wetherby Ln, Los Angeles, California |
| Authorized Official Name and Position | Mark Gobrial (PRESIDENT) |
| Authorized Official Contact | 8186676488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gap Post-acute Care Services Po Box 241040 Los Angeles CA 90024-1046 Ph: (310) 597-9705 | Gap Post-acute Care Services 11750 Wetherby Ln Los Angeles CA 90077-1348 Ph: (310) 597-9705 |
| NPI Number | 1194538264 |
|---|---|
| Provider Enumeration Date | 01/30/2025 |
| Last Update Date | 01/30/2025 |
| Medicare PECOS PAC ID | 9830619444 |
|---|---|
| Medicare Enrollment ID | O20250226002909 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194538264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shahab Attarchi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1902982408 PECOS PAC ID: 4385541911 Enrollment ID: I20031212000712 |
| Provider Name | Mark N Gobrial |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437577343 PECOS PAC ID: 5395017875 Enrollment ID: I20170817002825 |
| Provider Name | Jesse Liangyu Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902390990 PECOS PAC ID: 0840697496 Enrollment ID: I20210923002326 |
| Provider Name | Caroline Aguirre Go |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881308823 PECOS PAC ID: 5799159786 Enrollment ID: I20230314001540 |
| Provider Name | Caroline Park |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1396270989 PECOS PAC ID: 0840536157 Enrollment ID: I20240212001458 |
| Provider Name | Anthony Moradian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386350775 PECOS PAC ID: 4183065915 Enrollment ID: I20240510002750 |
| Provider Name | Galib Mirza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215518782 PECOS PAC ID: 5698128791 Enrollment ID: I20240829004388 |
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