MEDICARE: DR. DEREK WALLIN D.D.S.

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	1223G0001X	General Practice Dentistry	63850	CA

General Provider Information

NPI Number	:	1881090892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEREK WALLIN D.D.S.

Provider Business Mailing Address
First Line	:	2080 CENTURY PARK E STE 1601
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2019
Country	:	US
Telephone Number	:	310-277-5678
Fax Number	:

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E STE 1601
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2019
Country	:	US
Telephone Number	:	310-277-5678
Fax Number	:

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

Provider Enumeration Date	:	11/18/2014
Last Update Date	:	11/18/2014

Similar Medicare Providers

1932193893 — DR. RONALD SUE M.D.
Practice Location Address:

2080 CENTURY PARK E , SUTIE #1605
LOS ANGELES, CA
90067-2019

Practice Phone: 310-556-2244
Practice Fax: 310-556-4675

1396702320 — DR. STEVEN S GALEN M.D.
Practice Location Address:

2080 CENTURY PARK E STE 1609
LOS ANGELES, CA
90067-2019

Practice Phone: 310-277-1222
Practice Fax: 310-553-6929

1184936379 — DR. AARON CHIANG M.D.
Practice Location Address:

2080 CENTURY PARK E STE 1605
LOS ANGELES, CA
90067-2019

Practice Phone: 310-620-1888
Practice Fax:

1881909588 — DR SASAN MASSACHI INC
Practice Location Address:

2080 CENTURY PARK E STE 1609
LOS ANGELES, CA
90067-2019

Practice Phone: 310-553-3013
Practice Fax: 310-286-2184

1699262188 — ERIC R. SUE, M.D., INC.
Practice Location Address:

2080 CENTURY PARK E STE 1605
LOS ANGELES, CA
90067-2019

Practice Phone: 310-556-1800
Practice Fax: 310-556-1806

1902464449 — AARON C. CHIANG, M.D., INC.
Practice Location Address:

2080 CENTURY PARK E STE 1605
LOS ANGELES, CA
90067-2019

Practice Phone: 310-620-1888
Practice Fax:

Directions to “ DR. DEREK WALLIN D.D.S.” 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 © 2007-2026 (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.