Individual
DEIRDRE DENE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10300 COMPTON AVE, LOS ANGELES, CA 90002-3628
(323) 357-6582
(323) 563-3386
Mailing address
6641 S HALM AVE, LOS ANGELES, CA 90056-2225
(310) 403-8993
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A69173
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OOA691730
MEDI-CAL NOL
CA
Enumeration date
09/16/2006
Last updated
12/05/2011
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