Healthcare Provider Details

I. General information

NPI: 1619173267
Provider Name (Legal Business Name): COURTNEY C. J. VOELKER M.D., P.H.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11645 WILSHIRE BLVD STE 600
LOS ANGELES CA
90025-6807
US

IV. Provider business mailing address

11645 WILSHIRE BLVD STE 600
LOS ANGELES CA
90025-6807
US

V. Phone/Fax

Practice location:
  • Phone: 310-477-5558
  • Fax: 310-477-7281
Mailing address:
  • Phone: 310-477-5558
  • Fax: 310-477-7281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number036136305
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA120816
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberA120816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: