Provider Demographics
NPI:1639263254
Name:STANLEY I ORWASHER DPM A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:STANLEY I ORWASHER DPM A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ORWASHER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:310-278-6190
Mailing Address - Street 1:435 N ROXBURY DR
Mailing Address - Street 2:PH
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5027
Mailing Address - Country:US
Mailing Address - Phone:310-278-6190
Mailing Address - Fax:
Practice Address - Street 1:435 N ROXBURY DR
Practice Address - Street 2:PH
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5027
Practice Address - Country:US
Practice Address - Phone:310-278-6190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2005213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11130Medicare UPIN