Provider Demographics
NPI:1417051095
Name:HOUSE, JOHN W (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:HOUSE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2100 W 3RD ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1944
Mailing Address - Country:US
Mailing Address - Phone:213-483-9930
Mailing Address - Fax:213-483-0905
Practice Address - Street 1:2100 W 3RD ST
Practice Address - Street 2:SUITE 111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1944
Practice Address - Country:US
Practice Address - Phone:213-483-9930
Practice Address - Fax:213-483-0905
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2013-09-27
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Provider Licenses
StateLicense IDTaxonomies
CAG14971207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A39398Medicare UPIN
CAWG14971BMedicare PIN