MEDICARE: GARRY P. DIETER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	9767	MT
2	207L00000X	Anesthesiology Physician	9767	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811920002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARRY P. DIETER MD

Provider Business Mailing Address
First Line	:	757 WESTWOOD PLZ STE 3304
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-9780
Country	:	US
Telephone Number	:	310-267-0902
Fax Number	:

Provider Business Practice Location Address
First Line	:	UCLA DEPT ANESTHESIOLOGY AND PERIOP MEDICINE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-3129
Country	:	US
Telephone Number	:	310-267-8653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	09/08/2021

Similar Medicare Providers

1639166242 — 533 SOUTH FAIRFAX AVENUE INC
Practice Location Address:

533 S FAIRFAX AVE
LOS ANGELES, CA
90036-3129

Practice Phone: 323-931-1061
Practice Fax: 323-931-1943

1912948829 — GARFIELD BEACH CVS LLC
Practice Location Address:

3644 E OLYMPIC BLVD
LOS ANGELES, CA
90023-3129

Practice Phone: 323-264-0496
Practice Fax:

1801809603 — DR. SHEPARD KOKIN D.D.S.
Practice Location Address:

3129 GRANVILLE AVE
LOS ANGELES, CA
90066-1114

Practice Phone: 310-390-9611
Practice Fax:

1902930936 — JAVIER ELIECER JARA D.D.S
Practice Location Address:

3129 N SAN FERNANDO RD
LOS ANGELES, CA
90065-1412

Practice Phone: 323-257-7744
Practice Fax: 323-257-5430

1043344096 — YVETTE GULESSERIAN DDS
Practice Location Address:

3129 N SAN FERNANDO RD
LOS ANGELES, CA
90065-1412

Practice Phone: 323-257-7744
Practice Fax: 323-257-5430

1831211820 — DAE H SONG DDS INC
Practice Location Address:

3129 N SAN FERNANDO RD
LOS ANGELES, CA
90065-1412

Practice Phone: 323-257-7744
Practice Fax: 323-257-5430

Directions to “ GARRY P. DIETER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.