Organization
WESTSIDE PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE IAN KAGAN M.D., F.A.A.P. (OWNER)
(310) 500-5546
Entity
Organization
Contact information
Practice address
12301 WILSHIRE BLVD STE 120, LOS ANGELES, CA 90025-1099
(310) 500-5546
Mailing address
12301 WILSHIRE BLVD STE 120, LOS ANGELES, CA 90025-1099
(310) 500-5546
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A102946
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851562318
PERSONAL NPI
CA
Enumeration date
04/21/2010
Last updated
04/21/2010
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