Individual
GARRETT GRANNAN MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
433 N HOOVER ST, LOS ANGELES, CA 90004-2306
(323) 644-2000
Mailing address
357 S ALVARADO ST APT 309, LOS ANGELES, CA 90057-4512
(520) 221-3926
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-TZNKCE
CA
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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