Organization
WALLACE M KORBIN MD A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALLACE M KORBIN MD (PRESIDENT)
(818) 988-0170
Entity
Organization
Contact information
Practice address
15243 VANOWEN ST, SUITE #209, VAN NUYS, CA 91405
(818) 988-0170
(818) 367-0767
Mailing address
PO BOX 492267, LOS ANGELES, CA 90049
(818) 988-0170
(818) 367-0767
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
C18692
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C18692A
STATE OF CALIFORNIA
CA
Enumeration date
06/13/2007
Last updated
10/30/2007
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