Healthcare Provider Details

I. General information

NPI: 1841576097
Provider Name (Legal Business Name): WALTER ALAN OSIAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 WILSHIRE BLVD
LOS ANGELES CA
90025-6602
US

IV. Provider business mailing address

399 E 21ST ST
SAN BERNARDINO CA
92404-4815
US

V. Phone/Fax

Practice location:
  • Phone: 310-582-7900
  • Fax:
Mailing address:
  • Phone: 909-882-2266
  • Fax: 909-881-7593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA124224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: