Walter Van Vort

NPI 1013026160 - Psychiatry & Neurology - 2084P0800X

NPI Details
NPI 1013026160
Gender Male
Enumeration Date 08/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
11301 WILSHIRE BLVD # B116AA
LOS ANGELES CA, 90073-1003, US
Phone (310) 268-4449
Fax
Business Location
11301 WILSHIRE BLVD # B116AA
LOS ANGELES CA, 90073-1003, US
Phone
Fax
Toxanomy
Taxonomy Code 2084P0800X
License State California
License Number G63602
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According to our database, Walter Van Vort NPI is 1013026160, taxonomy code is 2084P0800X and license number is G63602, license state is located at California. Walter Van Vort physically located at 11301 Wilshire Blvd # B116aa, Los Angeles CA, 90073-1003. NPI Number Walter Van Vort has the Individual type.

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1013026160 NPI number is provided on an as is basis without warranty of any kind. 1013026160 is maintained by the National Plan & Provider Enumeration System. The contents of Walter Van Vort are for informational purposes only.