Provider Demographics
NPI:1699809251
Name:GLOOR MAUNG, PRISCA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PRISCA
Middle Name:
Last Name:GLOOR MAUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PRISCA
Other - Middle Name:
Other - Last Name:GLOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PH D
Mailing Address - Street 1:4055 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5411
Mailing Address - Country:US
Mailing Address - Phone:310-313-2215
Mailing Address - Fax:
Practice Address - Street 1:3200 MOTOR AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-3710
Practice Address - Country:US
Practice Address - Phone:310-204-1666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPS2006159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health