Healthcare Provider Details

I. General information

NPI: 1801073325
Provider Name (Legal Business Name): JULIE ANN GEDDEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 WESTWOOD PLAZA SUITE C8-222
LOS ANGELES CA
90024-1759
US

IV. Provider business mailing address

760 WESTWOOD PLAZA SUITE C8-222
LOS ANGELES CA
90022-1759
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-2467
  • Fax:
Mailing address:
  • Phone: 310-825-2467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA98356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: