MEDICARE: GAIL NALLS M.D.

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
1	2085U0001X	Diagnostic Ultrasound Physician	G47276	CA
2	2085B0100X	Body Imaging Physician	G47276	CA
3	2085D0003X	Diagnostic Neuroimaging (Radiology) Physician	G47276	CA
4	2085N0700X	Neuroradiology Physician	G47276	CA
5	2085N0904X	Nuclear Radiology Physician	G47276	CA
6	2085R0202X	Diagnostic Radiology Physician	G47276	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G47276C	OTHER	CA	MEDICARE
3	G47276A	OTHER	CA	MEDICARE
4	G47276B	OTHER	CA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770592768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL NALLS M.D.

Provider Business Mailing Address
First Line	:	6615 S HOLT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90056-2211
Country	:	US
Telephone Number	:	213-618-9719
Fax Number	:	310-337-1508

Provider Business Practice Location Address
First Line	:	2001 BEVERLY BLVD STE 218
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2403
Country	:	US
Telephone Number	:	213-618-9719
Fax Number	:	310-337-1508

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	12/18/2019

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Directions to “ GAIL NALLS M.D.” Practice Location

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