Individual
BENJAMIN WILLIAM WALLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
2080 CENTURY PARK E, #610, LOS ANGELES, CA 90067-2001
(310) 842-4811
(310) 286-2177
Mailing address
2080 CENTURY PARK E, #610, LOS ANGELES, CA 90067-2001
(310) 842-4811
(310) 286-2177
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
A98343
CA
Other
Enumeration date
08/30/2007
Last updated
10/16/2012
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