Provider Demographics
NPI:1457677981
Name:FELIX, GLADYS (MD)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:FELIX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 W SUNSET BLVD
Mailing Address - Street 2:MAIL STOP #76
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6062
Mailing Address - Country:US
Mailing Address - Phone:323-361-6161
Mailing Address - Fax:323-361-4429
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MAIL STOP #76
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-6161
Practice Address - Fax:323-361-4429
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA121109208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics