Healthcare Provider Details

I. General information

NPI: 1447028949
Provider Name (Legal Business Name): CHANA MEIER GELB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 SAN VICENTE BLVD STE 520
LOS ANGELES CA
90048-5455
US

IV. Provider business mailing address

1730 BAGLEY AVE
LOS ANGELES CA
90035-4110
US

V. Phone/Fax

Practice location:
  • Phone: 310-595-5632
  • Fax:
Mailing address:
  • Phone: 310-993-0076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: