Provider Demographics
NPI:1043310915
Name:LONDON, GARY DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:DEAN
Last Name:LONDON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10501 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1610
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6302
Mailing Address - Country:US
Mailing Address - Phone:310-446-5420
Mailing Address - Fax:310-446-5423
Practice Address - Street 1:9201 W SUNSET BLVD
Practice Address - Street 2:SUITE 902
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3701
Practice Address - Country:US
Practice Address - Phone:310-270-4500
Practice Address - Fax:310-446-5423
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2009-12-03
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Provider Licenses
StateLicense IDTaxonomies
CAG79372083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine