Healthcare Provider Details

I. General information

NPI: 1033063599
Provider Name (Legal Business Name): DLL PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 WILSHIRE BLVD STE 120
LOS ANGELES CA
90025-1099
US

IV. Provider business mailing address

11870 SANTA MONICA BLVD STE 106395
LOS ANGELES CA
90025-2276
US

V. Phone/Fax

Practice location:
  • Phone: 310-979-7337
  • Fax: 310-979-7338
Mailing address:
  • Phone: 310-979-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA LEWIS
Title or Position: PEDIATRICIAN
Credential: MD
Phone: 310-979-7337