Flagg, Gwenervere Louise
Flagg, Gwenervere Louise is an individual health care provider with primary practice located at 231 W Vernon Ave Suite 204, Los Angeles CA 90037-2700. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Transplant Surgery, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Transplant Surgery is her primary health care specialty. Flagg, Gwenervere Louise can be contacted via phone (323) 234-9595.Contact Information
Primary practice address
231 W Vernon Ave Suite 204
Los Angeles CA 90037-2700
Phone: (323) 234-9595
Fax: (323) 234-9588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Transplant Surgery | 204F00000X | G42472 | California |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | G42472 | California |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | G42472 | California |
Profile Details
| NPI number | 1548216674 |
|---|---|
| LBN Legal business name | Flagg, Gwenervere Louise |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 26th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548216674 | NPPES |
| California | MEDICAID | 00G424720 |
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