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NPI Code Detail

MEDICARE: ANNA R. GRELLERT

MEDICARE: ANNA R. GRELLERT
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1972792828
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA R. GRELLERT
Provider Business Mailing Address
First Line : 9808 VENICE BLVD STE 700
Second Line :
City : CULVER CITY
State : CA
Zip : 90232-6824
Country : US
Telephone Number : 310-945-3350
Fax Number : 310-840-7023
Provider Business Practice Location Address
First Line : 9808 VENICE BLVD STE 700
Second Line :
City : CULVER CITY
State : CA
Zip : 90232-6824
Country : US
Telephone Number : 310-945-3350
Fax Number : 310-840-7023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2007
Last Update Date : 10/16/2007

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Directions to “ ANNA R. GRELLERT ” Practice Location

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