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Individual

ALAN WAYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 361-4100
(323) 361-3642
Mailing address
6430 W SUNSET BLVD, SUITE 600, LOS ANGELES, CA 90028-7901
(323) 361-2337
(323) 361-8491

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D55485
MD
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
G89458
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
485300800
MD
01
KR4026CC
MEDICARE
MD
Enumeration date
06/22/2006
Last updated
01/06/2014
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