Individual
GREGORY S VAN DYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
12409 VENTURA CT, STE C, STUDIO CITY, CA 91604-2471
(818) 900-6007
(818) 900-6607
Mailing address
12409 VENTURA CT, STE C, STUDIO CITY, CA 91604-2471
(818) 900-6007
(818) 900-6607
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A81049
CA
207ZD0900X
Dermatopathology (Pathology) Physician
A81049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A810490
—
CA
Enumeration date
03/01/2007
Last updated
08/21/2019
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