Healthcare Provider Details

I. General information

NPI: 1043363120
Provider Name (Legal Business Name): DONALD LEWIS HEPLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ST PAUL AVE SUITE 100
LOS ANGELES CA
90017-2038
US

IV. Provider business mailing address

600 ST PAUL AVE SUITE 100
LOS ANGELES CA
90017-2038
US

V. Phone/Fax

Practice location:
  • Phone: 213-482-6400
  • Fax: 213-482-6412
Mailing address:
  • Phone: 213-482-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: