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Individual

DR. DALE ALAN PROKUPEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8641 WILSHIRE BLVD, SUITE 100, BEVERLY HILLS, CA 90211-2900
(310) 360-6807
(310) 360-6683
Mailing address
8641 WILSHIRE BLVD, STE 100, BEVERLY HILLS, CA 90211-2919
(310) 360-6807
(310) 360-6683

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G71035
CA
207RG0100X
Gastroenterology Physician
Primary
G71035
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1548569197
GROUP NPI
CA
Enumeration date
02/08/2007
Last updated
08/25/2017
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