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General NPI Number Information
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NPI Number | 1093148702
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Entity Type | Organization
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Legal Business Name | GREGORY M. ECKEL, MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/16/2013
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 14516 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260-1519
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Country | US
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Telephone | 310-923-5272
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Fax |
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Provider Business Mailing Address
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Address Line | 14516 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260-1519
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY M ECKEL
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Credential | MD
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Telephone | 310-923-5272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A72806
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License Number State | CA
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