Individual
IRENE KOOLWIJK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 UCLA MEDICAL PLZ STE 3300, LOS ANGELES, CA 90095-6062
(310) 825-0867
(310) 206-4855
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A121627
CA
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
A121627
CA
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
A121627
CA
Other
Enumeration date
06/29/2007
Last updated
04/26/2021
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