MEDICARE: ANTHONY P. GULLA AMFT

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	106H00000X	Marriage & Family Therapist	LMFT163167	CA

General Provider Information

NPI Number	:	1710731997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY P. GULLA AMFT

Provider Business Mailing Address
First Line	:	1341 N CRESCENT HEIGHTS BLVD APT 106
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-4542
Country	:	US
Telephone Number	:	310-770-9376
Fax Number	:

Provider Business Practice Location Address
First Line	:	1341 N CRESCENT HEIGHTS BLVD APT 106
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-4542
Country	:	US
Telephone Number	:	310-770-9376
Fax Number	:

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

Provider Enumeration Date	:	04/15/2024
Last Update Date	:	05/08/2026

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