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General NPI Number Information
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NPI Number | 1144544412
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Entity Type | Organization
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Legal Business Name | LINDI H. VANDERWALDE, MD INC.
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Dates
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Enumeration Date | 03/16/2010
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 8900 WILSHIRE BLVD
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1958
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Country | US
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Telephone | 310-432-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 1880 CENTURY PARK E SUITE 200
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City | LOS ANGELES
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State | CA
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Zip | 90067-1600
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Country | US
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Telephone | 310-289-9333
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Fax | 310-552-1626
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Authorized Official
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Title or Position | SURGEON
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Name | DR. LINDI H VANDERWALDE
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Credential | MD
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Telephone | 310-421-8225
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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 | A94946
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License Number State | CA
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