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Individual

DR. GARY SPENCER FELTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10780 SANTA MONICA BLVD STE 450 SUITE 450, LOS ANGELES, CA 90025-7635
(310) 281-5531
(310) 559-8743
Mailing address
10780 SANTA MONICA BLVD STE 450, SUITE #450, LOS ANGELES, CA 90025-7635
(310) 281-5531
(310) 559-8743

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY3673
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY3673
STATE LICENSE NUMBER
CA
Enumeration date
05/17/2007
Last updated
07/08/2007
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