Doctor Name: | DR. MICHAEL J GILEWSKI |
NPI Number: | 1811993389 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | PSY 9194 |
Business Practice Address: | 444 S San Vicente Blvd Ste 701 Los Angeles, CA - 900484174 |
Business Phone Number: | 3104232715 |
Business Fax Number: | 3104239290 |
Mailing Address: | 444 S San Vicente Blvd, Ste 701 LOS ANGELES |
State: | CA |
Postal Code: | 900484174 |
Phone Number: | 3104232715 |
Fax Number: | 3104239290 |
NPI Enumeration Date: | 06/21/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PSY 9194 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |