Individual
MS. DEBORAH WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, OCN, PMN
Contact information
Practice address
9090 WILSHIRE BLVD, SUITE 200, BEVERLY HILLS, CA 90211-1850
(310) 888-8680
Mailing address
812 CAMINO REAL UNIT 102, REDONDO BEACH, CA 90277-4301
(424) 247-3150
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95004542
CA
Other
Enumeration date
08/31/2016
Last updated
10/11/2016
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