Provider Demographics
NPI:1356891857
Name:GENDLER, ELI (MD)
Entity type:Individual
Prefix:MR
First Name:ELI
Middle Name:
Last Name:GENDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 1/2 CALIFORNIA AVE
Mailing Address - Street 2:UPPER UNIT
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403
Mailing Address - Country:US
Mailing Address - Phone:213-840-8795
Mailing Address - Fax:213-745-3031
Practice Address - Street 1:2501 SOUTH HILL ST.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007
Practice Address - Country:US
Practice Address - Phone:213-840-8795
Practice Address - Fax:213-536-5845
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA39904208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice