Individual
DAVID WALLENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1920 COLORADO AVE, SANTA MONICA, CA 90404-3414
(310) 319-4700
(310) 453-5106
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A81052
CA
207R00000X
Internal Medicine Physician
A81052
CA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
A81052
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A810520
—
CA
Enumeration date
07/31/2006
Last updated
11/25/2019
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