Physician Compare National (NPI:1760568901)

HEALTHCARE PROVIDER: WALTER D DISHELL MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1760568901
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284759572
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100909000909
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DISHELL
	Individual professional last name
Provider First Name	WALTER
	Individual professional first name
Provider Middle Name	D
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1964
	Individual professional's medical school graduation year
Primary Specialty	OTOLARYNGOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PLASTIC AND RECONSTRUCTIVE SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PLASTIC AND RECONSTRUCTIVE SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	16311 VENTURA BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 550
	Group Practice or individual's line 2 address
City	ENCINO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	914364314
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8189867900
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y