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Organization

GREAT HARBOR FAMILY & SPORTS MEDICINE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELISSA SCHLICHTER D.O. (MEDICAL DIRECTOR)
(310) 521-1311
Entity
Organization

Contact information

Practice address
1294 W 6TH ST, SUITE 200, SAN PEDRO, CA 90731-2987
(310) 521-1311
(310) 514-1313
Mailing address
1294 W 6TH ST, SUITE 200, SAN PEDRO, CA 90731-2987
(310) 521-1311
(310) 514-1313

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20A7368
CA

Other

Enumeration date
04/19/2007
Last updated
08/22/2020
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