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Individual

DR. VAN DYKE DEGOLIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11980 SAN VICENTE BLVD, SUITE 902, LOS ANGELES, CA 90049-5012
(310) 826-1915
(310) 826-1975
Mailing address
11980 SAN VICENTE BLVD, SUITE 902, LOS ANGELES, CA 90049-5012
(310) 826-1915
(310) 826-1975

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
G50306
CA

Other

Enumeration date
02/06/2007
Last updated
07/08/2007
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