Healthcare Provider Details

I. General information

NPI: 1639263254
Provider Name (Legal Business Name): STANLEY I ORWASHER DPM A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N ROXBURY DR PH
BEVERLY HILLS CA
90210-5027
US

IV. Provider business mailing address

435 N ROXBURY DR PH
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: DR. STANLEY ORWASHER
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 310-278-6190