Martin Ellis Widzer MD

NPI 1689836066 - Psychiatry & Neurology - 2084P0800X

NPI Details
NPI 1689836066
Gender Male
Enumeration Date 06/27/2008
Last Updated 06/27/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
11980 SAN VICENTE BLVD
SUITE #708
LOS ANGELES CA, 90049-6605, US
Phone (310) 442-2242
Fax (310) 472-0030
Business Location
11980 SAN VICENTE BLVD
SUITE #708
LOS ANGELES CA, 90049-6605, US
Phone (310) 442-2242
Fax (310) 472-0030
Toxanomy
Taxonomy Code 2084P0800X
License State California
License Number C29362
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According to our database, Martin Ellis Widzer MD NPI is 1689836066, taxonomy code is 2084P0800X and license number is C29362, license state is located at California. Martin Ellis Widzer MD physically located at 11980 San Vicente Blvd, Los Angeles CA, 90049-6605. NPI Number Martin Ellis Widzer MD has the Individual type.

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1689836066 NPI number is provided on an as is basis without warranty of any kind. 1689836066 is maintained by the National Plan & Provider Enumeration System. The contents of Martin Ellis Widzer MD are for informational purposes only.