Walter D Dishell MD a Medical Clinic

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

C274780 Issued in CA

Legal business name

WALTER D DISHELL MD A MEDICAL CLINIC

Practice address

16311 Ventura Blvd
Suite 550
Encino, CA 91436-2124

Phone

(818) 986-7900

Fax

(818) 986-7952

NPI assigned

Jun 1, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Walter D Dishell, M.D.

Title

President

Phone

(818) 986-7900

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1366762338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "SUITE 550",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "818-986-7900",
            "fax_number": "818-986-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "SUITE 550",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "818-986-7900",
            "fax_number": "818-986-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER D DISHELL MD A MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-01",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "DISHELL",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-986-7900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "C274780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1760568901",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tionnie Walls
• Wesley Grant Walters, LMFT
• Jessica Ann Wang
• Maegan Wang
• Michelle Z. Wang, M.D.
• Yu-Chen Wang, OTR/L

• Facial Plastic Surgery Physician in Encino, CA
• Providers in Encino, CA by specialty
• Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.