Wallen, Eleanor Andrea

Wallen, Eleanor Andrea is an sole proprietor health care provider with primary practice located at 4418 Vineland Ave Suite 215, Toluca Lake CA 91602-3457. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as her primary health care specialty. Wallen, Eleanor Andrea can be contacted via phone (818) 980-3383.

Contact Information

Primary practice address
4418 Vineland Ave Suite 215 Toluca Lake CA 91602-3457
Phone: (818) 980-3383
Fax: (818) 980-5383
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X E3573 California

Profile Details

NPI number 1457394694
LBN Legal business name Wallen, Eleanor Andrea
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Sep 28th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457394694 NPPES
California Other W21231 MEDICARE PTAN GROUP

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