Vanderbilt, Douglas L
Vanderbilt, Douglas L is an individual health care provider with primary practice located at 4650 W Sunset Blvd Ms#76, Los Angeles CA 90027-6062. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. Vanderbilt, Douglas L can be contacted via phone (617) 414-5170.Contact Information
Primary practice address
4650 W Sunset Blvd Ms#76
Los Angeles CA 90027-6062
Phone: (617) 414-5170
Fax: (323) 361-8566
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | 213549 | Massachusetts |
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | A75123 | California |
Profile Details
| NPI number | 1457340291 |
|---|---|
| LBN Legal business name | Vanderbilt, Douglas L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2005 |
| Last updated | Jul 24th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457340291 | NPPES |
| Massachusetts | MEDICAID | 0179540 |
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