Organization
VA GREATER LOS ANGELES MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WALLACE EISNER RKT (KINESIOTHERAPIST)
(310) 478-3711
Entity
Organization
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073
(310) 478-3711
Mailing address
12122 EXCELSIOR DRIVE, NORWALK, CA 90650
(562) 863-6315
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
1031
CA
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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