Individual
DR. DOUGLAS L VANDERBILT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4650 W SUNSET BLVD, MS#76, LOS ANGELES, CA 90027-6062
(617) 414-5170
(323) 361-8566
Mailing address
6430 W SUNSET BLVD, SUITE 600, LOS ANGELES, CA 90028-7900
(323) 361-2337
(323) 361-8491
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
213549
MA
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
A75123
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0179540
—
MA
Enumeration date
10/14/2005
Last updated
07/24/2009
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