Organization
WARREN S LINE JR MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN SCOTT LINE JR. MD (PRESIDENT)
(818) 763-7366
Entity
Organization
Contact information
Practice address
191 S BUENA VISTA ST, SUITE #320, BURBANK, CA 91505
(818) 763-7366
(818) 763-1809
Mailing address
191 SOUTH BUENA VISTA STREET, SUITE #320, BURBANK, CA 91505
(818) 763-7366
(818) 763-1809
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G48150
CA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
G48150
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6177618
—
CA
Enumeration date
06/04/2008
Last updated
06/04/2008
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