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NPI Code Detail

MEDICARE: DIETER ENZMANN MD

MEDICARE: DIETER ENZMANN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085N0700XNeuroradiology PhysicianG26559CA
22085R0204XVascular & Interventional Radiology PhysicianG26559CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598723801
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIETER ENZMANN MD
Provider Business Mailing Address
First Line : 5767 W. CENTURY BLVD
Second Line : #400
City : LOS ANGELES
State : CA
Zip : 90045-5655
Country : US
Telephone Number : 310-301-6800
Fax Number :
Provider Business Practice Location Address
First Line : 10833 LE CONTE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-3075
Country : US
Telephone Number : 310-301-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 07/05/2026

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