Individual
DR. DONALD E. WALLENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2080 CENTURY PARK E STE 1406, LOS ANGELES, CA 90067-2017
(310) 556-2095
(310) 556-2063
Mailing address
2080 CENTURY PARK E STE 1406, LOS ANGELES, CA 90067-2017
(310) 556-2095
(310) 556-2063
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G12632
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006126320
—
CA
Enumeration date
09/22/2006
Last updated
09/24/2020
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