Organization
WALTER D DISHELL MD A MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER D DISHELL M.D. (PRESIDENT)
(818) 986-7900
Entity
Organization
Contact information
Practice address
16311 VENTURA BLVD, SUITE 550, ENCINO, CA 91436-2124
(818) 986-7900
(818) 986-7952
Mailing address
16311 VENTURA BLVD, SUITE 550, ENCINO, CA 91436-2124
(818) 986-7900
(818) 986-7952
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
C274780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760568901
INDIVIDUAL NPI
CA
Enumeration date
06/01/2010
Last updated
09/03/2010
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