Provider Demographics
NPI:1588651905
Name:OSTERWEIL, DAN (MD, FACP,CMD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:
Last Name:OSTERWEIL
Suffix:
Gender:M
Credentials:MD, FACP,CMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1793
Mailing Address - Country:US
Mailing Address - Phone:818-986-7908
Mailing Address - Fax:818-986-9308
Practice Address - Street 1:5000 VAN NUYS BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1793
Practice Address - Country:US
Practice Address - Phone:818-986-7908
Practice Address - Fax:818-986-9308
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41240207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA412400Medicaid
CAA412400Medicaid
A85589Medicare UPIN