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1578926325
MIRA SHANKS GRACER
LOS ANGELES, CA
NPI
1578926325
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: CA A148239)
Enumeration Date
2016-03-30
Last Update Date
2018-07-23
Business Address
MIRA SHANKS GRACER MD
1200 N STATE ST
LOS ANGELES, CA 90033
Phone number: 323-409-5555
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Mailing Address
MIRA SHANKS GRACER MD
1200 N STATE ST
LOS ANGELES, CA 90033-1029
Phone number: 323-409-5555
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