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NPI Code Detail

MEDICARE: GARY SEIDEN

MEDICARE: GARY SEIDEN
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
1101YA0400XAddiction (Substance Use Disorder) CounselorC053660518CA

General Provider Information

NPI Number : 1518814730
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY SEIDEN
Provider Business Mailing Address
First Line : 340 S LA FAYETTE PARK PL APT 308
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-1639
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1002 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1416
Country : US
Telephone Number : 310-314-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ GARY SEIDEN ” Practice Location

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