Organization
GREGG SMALL MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGG SMALL M.D. (OWNER)
(818) 907-7828
Entity
Organization
Contact information
Practice address
15720 VENTURA BLVD, SUITE 227, ENCINO, CA 91436-2914
(818) 907-7828
Mailing address
15720 VENTURA BLVD, SUITE 227, ENCINO, CA 91436-2914
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G70119
CA
Other
Enumeration date
03/26/2008
Last updated
04/01/2008
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