Healthcare Provider Details

I. General information

NPI: 1164619904
Provider Name (Legal Business Name): MICHELLE MARIE GERBER N.D., LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11340 W OLYMPIC BLVD SUITE 301
LOS ANGELES CA
90064-1608
US

IV. Provider business mailing address

2241 MEADOWVALE AVE
LOS ANGELES CA
90031-1108
US

V. Phone/Fax

Practice location:
  • Phone: 310-914-5010
  • Fax: 310-914-3332
Mailing address:
  • Phone: 323-678-1025
  • Fax: 310-914-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM243
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: