MEDICARE: DR. GLENN FRANCIS VRABEL PSYD

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	103T00000X	Psychologist	PSY 20352	CA
2	103TC0700X	Clinical Psychologist	PSY 20352	CA

General Provider Information

NPI Number	:	1447217781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GLENN FRANCIS VRABEL PSYD

Provider Business Mailing Address
First Line	:	550 S VERMONT AVE
Second Line	:	10TH FLOOR
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-1912
Country	:	US
Telephone Number	:	213-305-3030
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 S VERMONT AVE
Second Line	:	10TH FLOOR
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-1912
Country	:	US
Telephone Number	:	213-305-3030
Fax Number	:

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	09/28/2011

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