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General NPI Number Information
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NPI Number | 1487849238
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Entity Type | Organization
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Legal Business Name | GRETCHEN A HETZLER MD INCORPORATED
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 10861 CHERRY ST SUITE 300
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-5402
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Country | US
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Telephone | 562-594-8320
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Fax | 562-594-9757
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Provider Business Mailing Address
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Address Line | 10861 CHERRY ST STE 105
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-5403
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Country | US
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Telephone | 562-594-8320
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Fax | 562-594-9757
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Authorized Official
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Title or Position | OWNER
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Name | DR. GRETCHEN HETZLER
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Credential | MD
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Telephone | 562-594-8320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | G058400
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License Number State | CA
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