MEDICARE: CAROL LEAH GELBARD

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1912624222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL LEAH GELBARD

Provider Business Mailing Address
First Line	:	2742 ANCHOR AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-4604
Country	:	US
Telephone Number	:	310-558-3050
Fax Number	:

Provider Business Practice Location Address
First Line	:	2742 ANCHOR AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-4604
Country	:	US
Telephone Number	:	310-558-3050
Fax Number	:

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

Provider Enumeration Date	:	10/26/2022
Last Update Date	:	10/26/2022

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Directions to “ CAROL LEAH GELBARD ” Practice Location

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