Van Dyke, Gregory S
Van Dyke, Gregory S is an sole proprietor health care provider with primary practice located at 12409 Ventura Ct Ste C, Studio City CA 91604-2471. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Van Dyke, Gregory S can be contacted via phone (818) 900-6007.Contact Information
Primary practice address
12409 Ventura Ct Ste C
Studio City CA 91604-2471
Phone: (818) 900-6007
Fax: (818) 900-6607
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | A81049 | California |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | A81049 | California |
Profile Details
| NPI number | 1841328614 |
|---|---|
| LBN Legal business name | Van Dyke, Gregory S |
| Credentials | MD, PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 1st, 2007 |
| Last updated | Aug 21st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841328614 | NPPES |
| California | MEDICAID | 00A810490 |
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