MID VALLEY DERMATOLOGICAL SURGERY CENTER – NPI #1295792505
Clinic/Center

MID VALLEY DERMATOLOGICAL SURGERY CENTER is an AHC clinic located in SHERMAN OAKS, CA. NPPES has assigned the NPI number 1295792505 to MID VALLEY DERMATOLOGICAL SURGERY CENTER on April 28, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MID VALLEY DERMATOLOGICAL SURGERY CENTER” is a dba name, the actual legal business name for this organization is ALLAN S. WIRTZER. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 18 years ago on Nov 13, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MID VALLEY DERMATOLOGICAL SURGERY CENTER below.

NPI Profile for
ALLAN S. WIRTZER

NPI Number
1295792505
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ALLAN S. WIRTZER
Doing Business As (dba): MID VALLEY DERMATOLOGICAL SURGERY CENTER
Primary location
4836 VAN NUYS BLVD
SHERMAN OAKS, CA 91403-2101
Phone: (818) 907-7546 Fax: (818) 907-9506
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
ALLAN WIRTZER
MEDICAL DIRECTOR
Phone: (818) 907-7546
Updated
Identifiers

Identifiers for MID VALLEY DERMATOLOGICAL SURGERY CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERALLAN S. WIRTZER MD, MEDICAL DIRECTOR NPI#CA1326003161
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)		 CA 261QA1903X

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.