Organization
VA GREATER LOS ANGELES MEDICAL CENTER
Active
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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