| Gabriel Lanum Licensed Marriage & Family Therapy Inc | |
|
212 N Catalina Ave Apt A Redondo Beach CA 90277-2853 | |
| (424) 241-2838 | |
| Not Available |
| Full Name | Gabriel Lanum Licensed Marriage & Family Therapy Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 212 N Catalina Ave Apt A, Redondo Beach, California |
| Authorized Official Name and Position | Gabriel Lanum (OWNER) |
| Authorized Official Contact | 4242412838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gabriel Lanum Licensed Marriage & Family Therapy Inc 318 Avenue I Unit 859 Redondo Beach CA 90277-5601 Ph: (424) 241-2838 | Gabriel Lanum Licensed Marriage & Family Therapy Inc 212 N Catalina Ave Apt A Redondo Beach CA 90277-2853 Ph: (424) 241-2838 |
| NPI Number | 1295583821 |
|---|---|
| Provider Enumeration Date | 05/08/2024 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 2365988342 |
|---|---|
| Medicare Enrollment ID | O20240725004755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295583821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Gabriel Lanum |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1629682505 PECOS PAC ID: 6800246000 Enrollment ID: I20240102000035 |
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