Healthcare Provider Details

I. General information

NPI: 1164515730
Provider Name (Legal Business Name): STANLEY ORWASHER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N. ROXBURY DRIVE
BEVERLY HILLS CA
90210-5027
US

IV. Provider business mailing address

435 N. ROXBURY DRIVE
BEVERLY HILLS CA
90210-5027
US

V. Phone/Fax

Practice location:
  • Phone: 310-278-6190
  • Fax:
Mailing address:
  • Phone: 310-278-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE2005
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: