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NPI Code Detail

MEDICARE: DANIELLE GRADELER PHARMD

MEDICARE: DANIELLE GRADELER PHARMD
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
1183500000XPharmacist69966CA

General Provider Information

NPI Number : 1558786913
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE GRADELER PHARMD
Provider Business Mailing Address
First Line : 11795 W OLYMPIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1211
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11795 W OLYMPIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1211
Country : US
Telephone Number : 310-312-6506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2014
Last Update Date : 02/21/2014

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Directions to “ DANIELLE GRADELER PHARMD” Practice Location

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