Provider Demographics
NPI:1285859967
Name:HOLLYWOOD HEALTH CENTER
Entity Type:Organization
Organization Name:HOLLYWOOD HEALTH CENTER
Other - Org Name:HOLLYWOOD HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DASHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-461-9355
Mailing Address - Street 1:321 N LARCHMONT BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-3025
Mailing Address - Country:US
Mailing Address - Phone:323-461-9355
Mailing Address - Fax:323-461-7257
Practice Address - Street 1:321 N LARCHMONT BLVD STE 404
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-6404
Practice Address - Country:US
Practice Address - Phone:323-461-9355
Practice Address - Fax:323-800-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty