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NPI Code Detail

MEDICARE: MR. GABI LOTFI DEAK LCSW

MEDICARE: MR. GABI LOTFI DEAK LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker23059CA

General Provider Information

NPI Number : 1730436569
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GABI LOTFI DEAK LCSW
Provider Business Mailing Address
First Line : 11340 W OLYMPIC BLVD STE 365
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1639
Country : US
Telephone Number : 310-479-4224
Fax Number :
Provider Business Practice Location Address
First Line : 11340 W OLYMPIC BLVD STE 365
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1639
Country : US
Telephone Number : 310-479-4224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2012
Last Update Date : 08/10/2012

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