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General NPI Number Information
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NPI Number | 1770868564
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Entity Type | Organization
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Legal Business Name | MICHAEL GADSBY, M.D., INCORPORATED
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/22/2011
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Provider Practice Location Address
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Address Line | 8717 LA TIJERA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90045-3906
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Country | US
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Telephone | 213-505-4556
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 92133
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City | PASADENA
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State | CA
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Zip | 91109-2133
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Country | US
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Telephone | 213-505-4556
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL GADSBY
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Credential | M.D.
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Telephone | 213-505-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G77223
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License Number State | CA
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