Individual
CAROLINE LEE WALLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2625 W ALAMEDA AVE STE 310, BURBANK, CA 91505-4819
(310) 794-7700
(818) 260-8718
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
A113187
CA
208800000X
Urology Physician
Primary
A113187
CA
Other
Enumeration date
03/28/2009
Last updated
01/08/2020
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