# ALLAN S. WIRTZER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MID VALLEY DERMATOLOGICAL SURGERY CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295792505
- **Authorized official:** ALLAN STANLEY WIRTZER M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 907-7546

## Contact information

- **Practice address:** 4836 VAN NUYS BLVD, SHERMAN OAKS, CA 91403-2101
- **Practice address phone:** (818) 907-7546
- **Practice address fax:** (818) 907-9506
- **Mailing address:** 4836 VAN NUYS BLVD, SHERMAN OAKS, CA 91403-2101
- **Mailing address phone:** (818) 907-7546
- **Mailing address fax:** (818) 907-9506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 261QA1903X | CA | Yes |

## Other

- **Enumeration date:** 04/28/2006
- **Last updated:** 11/13/2008