Individual
MANUEL GREGORIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16500 VENTURA BLVD STE 414, ENCINO, CA 91436-5050
(818) 788-1003
Mailing address
3527 MENTONE AVE, LOS ANGELES, CA 90034-4829
(424) 234-0602
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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