Healthcare Provider Details

I. General information

NPI: 1154281061
Provider Name (Legal Business Name): GREGORY JAMES GELBER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 OVERLAND AVE APT 6188
LOS ANGELES CA
90034-4513
US

IV. Provider business mailing address

3219 OVERLAND AVE APT 6188
LOS ANGELES CA
90034-4513
US

V. Phone/Fax

Practice location:
  • Phone: 310-709-4415
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: