Basic Information
| Provider Information | |||||||||
| NPI: | 1265426886 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GASKE | ||||||||
| FirstName: | ABBEY | ||||||||
| MiddleName: | BETH | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GERSHBEIN | ||||||||
| OtherFirstName: | ABBEY | ||||||||
| OtherMiddleName: | BETH | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1127 WILSHIRE BLVD | ||||||||
| Address2: | SUITE 1001 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900173901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2139771176 | ||||||||
| FaxNumber: | 2139770668 | ||||||||
| Practice Location | |||||||||
| Address1: | 1127 WILSHIRE BLVD | ||||||||
| Address2: | SUITE 1001 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900173901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2139771176 | ||||||||
| FaxNumber: | 2139770668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2005 | ||||||||
| LastUpdateDate: | 01/26/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | A72385 | CA | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.