Basic Information
Provider Information
NPI: 1528004660
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GABOR
FirstName: HOWARD
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2505
Address2:  
City: SALEM
State: OR
PostalCode: 973082505
CountryCode: US
TelephoneNumber: 8888283197
FaxNumber:  
Practice Location
Address1: 455 SAINT MICHAELS DR
Address2:  
City: SANTA FE
State: NM
PostalCode: 875057601
CountryCode: US
TelephoneNumber: 5059833361
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/20/2006
LastUpdateDate: 02/19/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X93-261NMY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
18900401 RIO PRIMARY CAREOTHER
0001525605NM MEDICAID
237401 LOVELACEOTHER
1492401 PRESBY- TERIANOTHER


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