Provider Demographics
NPI:1528570678
Name:DOSSIER HEALTH MANAGEMENT
Entity Type:Organization
Organization Name:DOSSIER HEALTH MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-823-4352
Mailing Address - Street 1:138 N BRAND BLVD STE 200-106
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4614
Mailing Address - Country:US
Mailing Address - Phone:818-823-4352
Mailing Address - Fax:818-230-9029
Practice Address - Street 1:138 N BRAND BLVD STE 200-106
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4614
Practice Address - Country:US
Practice Address - Phone:818-823-4352
Practice Address - Fax:818-230-9029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82437207KA0200X
332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty