Organization
THEODORE R. CORWIN, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE R CORWIN M.D. (PRESIDENT)
(805) 494-3656
Entity
Organization
Contact information
Practice address
911 HAMPSHIRE RD STE 1, WESTLAKE VILLAGE, CA 91361-2833
(805) 494-3656
(805) 778-9104
Mailing address
911 HAMPSHIRE RD STE 1, WESTLAKE VILLAGE, CA 91361-2833
(805) 494-3656
(805) 778-9104
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
G29196
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G291960
BLUE SHIELD PIN
CA
01
—
G29196
BLUE CROSS PIN
CA
Enumeration date
11/09/2006
Last updated
06/05/2009
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