MEDICARE: GILI DEKEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	19064	CA

General Provider Information

NPI Number	:	1346256971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILI DEKEL

Provider Business Mailing Address
First Line	:	12113 SANTA MONICA BLVD STE 203
Second Line	:
City	:	WEST LOS ANGELES
State	:	CA
Zip	:	90025-2581
Country	:	US
Telephone Number	:	310-309-3721
Fax Number	:	310-309-3724

Provider Business Practice Location Address
First Line	:	12113 SANTA MONICA BLVD STE 203
Second Line	:
City	:	WEST LOS ANGELES
State	:	CA
Zip	:	90025-2581
Country	:	US
Telephone Number	:	310-309-3721
Fax Number	:	310-309-3724

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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Directions to “ GILI DEKEL ” Practice Location

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