Individual
GRETCHEN STIPEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 E 28TH ST, STE 200, LONG BEACH, CA 90806-2759
(562) 933-7880
(562) 933-7869
Mailing address
DEPT LA 21749, PASADENA, CA 91185-1749
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101-238974
VA
2085R0202X
Diagnostic Radiology Physician
Primary
G84142
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G841420
BS
CA
05
—
00G841420
—
CA
Enumeration date
05/16/2006
Last updated
12/12/2007
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