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Organization

CHILD NEUROLOGY OF BEVERLY HILLS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHELE MARIE VAN HIRTUM-DAS M.D. (PRESIDENT)
(818) 788-7857
Entity
Organization

Contact information

Practice address
501 W GLENOAKS BLVD, # 705, GLENDALE, CA 91202-2896
(818) 788-7857
(818) 788-7857
Mailing address
501 W GLENOAKS BLVD, # 705, GLENDALE, CA 91202-2896
(818) 788-7857
(818) 788-7857

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
A73193
CA
261QM2500X
Medical Specialty Clinic/Center
A73193
CA

Other

Enumeration date
07/23/2008
Last updated
02/10/2014
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