MEDICARE: GRACEFULL BIRTHING INC

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	261QB0400X	Birthing Clinic/Center

General Provider Information

NPI Number	:	1609295955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEFULL BIRTHING INC

Provider Business Mailing Address
First Line	:	2815 W SUNSET BLVD STE 105
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-2168
Country	:	US
Telephone Number	:	323-963-3868
Fax Number	:	323-430-8054

Provider Business Practice Location Address
First Line	:	2815 W SUNSET BLVD STE 105
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-2168
Country	:	US
Telephone Number	:	323-379-4614
Fax Number	:	323-430-8054

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZABETH BACHNER
Credential	:
Telephone Number	:	323-963-3868

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	05/01/2015

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Directions to “GRACEFULL BIRTHING INC ” Practice Location

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