Healthcare Provider Details

I. General information

NPI: 1336461417
Provider Name (Legal Business Name): JANICE PATRICIA HANDLERS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 W OLYMPIC BLVD SUITE 390
LOS ANGELES CA
90064-1524
US

IV. Provider business mailing address

11500 W OLYMPIC BLVD SUITE 390
LOS ANGELES CA
90064-1524
US

V. Phone/Fax

Practice location:
  • Phone: 310-235-1164
  • Fax: 310-235-1067
Mailing address:
  • Phone: 310-235-1164
  • Fax: 310-235-1067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number27293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: