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General NPI Number Information
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NPI Number | 1518814730
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Entity Type | Individual
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Provider Name | GARY SEIDEN
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Gender | Male
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 1002 PICO BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90405-1416
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Country | US
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Telephone | 310-314-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 340 S LA FAYETTE PARK PL APT 308
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City | LOS ANGELES
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State | CA
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Zip | 90057-1639
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C053660518
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License Number State | CA
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