Provider Demographics
NPI:1811101520
Name:VARIS, GILA BLEI (LAC)
Entity type:Individual
Prefix:
First Name:GILA
Middle Name:BLEI
Last Name:VARIS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 ALVIRA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4612
Mailing Address - Country:US
Mailing Address - Phone:323-422-6930
Mailing Address - Fax:
Practice Address - Street 1:1711 ALVIRA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4612
Practice Address - Country:US
Practice Address - Phone:323-422-6930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 6266171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist