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1013026160
WALTER VAN VORT
LOS ANGELES, CA
NPI
1013026160
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: CA g63602)
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
-- WALTER VAN VORT
11301 WILSHIRE BLVD # B116AA
LOS ANGELES, CA 90073-1003
Phone number: 310-268-4449
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Mailing Address
-- WALTER VAN VORT
11301 WILSHIRE BLVD # B116AA
LOS ANGELES, CA 90073-1003
Phone number:
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