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General NPI Number Information
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NPI Number | 1003673815
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Entity Type | Organization
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Legal Business Name | DEAN PRINCE MD INC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 14501 CALVERT ST STE 200
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City | VAN NUYS
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State | CA
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Zip | 91411-2806
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Country | US
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Telephone | 310-987-7873
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Fax |
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Provider Business Mailing Address
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Address Line | 14501 CALVERT ST STE 200
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City | VAN NUYS
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State | CA
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Zip | 91411-2806
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Country | US
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Telephone | 310-987-7873
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEAN PRINCE
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Credential | MD
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Telephone | 310-987-7873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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