Organization
ALLAN S. WIRTZER
Active
Other names
MID VALLEY DERMATOLOGICAL SURGERY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ALLAN STANLEY WIRTZER M.D. (MEDICAL DIRECTOR)
(818) 907-7546
Entity
Organization
Contact information
Practice address
4836 VAN NUYS BLVD, SHERMAN OAKS, CA 91403-2101
(818) 907-7546
(818) 907-9506
Mailing address
4836 VAN NUYS BLVD, SHERMAN OAKS, CA 91403-2101
(818) 907-7546
(818) 907-9506
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
261QA1903X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326003161
ALLAN S. WIRTZER MD, MEDICAL DIRECTOR NPI#
CA
Enumeration date
04/28/2006
Last updated
11/13/2008
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