Healthcare Provider Details

I. General information

NPI: 1972048916
Provider Name (Legal Business Name): DYLAN OCHAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2016
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N ROBERTSON BLVD STE 404
BEVERLY HILLS CA
90211-1789
US

IV. Provider business mailing address

250 N ROBERTSON BLVD STE 404
BEVERLY HILLS CA
90211-1789
US

V. Phone/Fax

Practice location:
  • Phone: 310-273-9533
  • Fax:
Mailing address:
  • Phone: 310-273-9533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA154772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: