Provider Demographics
NPI:1225338338
Name:FROHLICH, GARY S (MS, CGC)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:S
Last Name:FROHLICH
Suffix:
Gender:M
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 HANLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1306
Mailing Address - Country:US
Mailing Address - Phone:310-471-0080
Mailing Address - Fax:310-471-8062
Practice Address - Street 1:1048 HANLEY AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-1306
Practice Address - Country:US
Practice Address - Phone:310-471-0080
Practice Address - Fax:310-471-8062
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS