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General NPI Number Information
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NPI Number | 1093084535
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Entity Type | Organization
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Legal Business Name | GARY R SCHLECTER MD INC
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Dates
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Enumeration Date | 12/28/2011
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 4900 OVERLAND AVE UNIT 322
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City | CULVER CITY
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State | CA
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Zip | 90230-4292
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Country | US
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Telephone | 310-560-1885
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 OVERLAND AVE UNIT 322
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City | CULVER CITY
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State | CA
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Zip | 90230-4292
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Country | US
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Telephone | 310-560-1885
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | GARY R SCHLECTER
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Credential | M.D.
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Telephone | 310-560-1885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | G319090
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License Number State | CA
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