Provider Demographics
NPI:1679884472
Name:WEST, DARA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:MICHELLE
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:MICHELLE
Other - Last Name:BIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1450 SAN PABLO ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-4500
Mailing Address - Country:US
Mailing Address - Phone:323-442-6335
Mailing Address - Fax:323-442-6338
Practice Address - Street 1:1450 SAN PABLO ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-4500
Practice Address - Country:US
Practice Address - Phone:323-442-6335
Practice Address - Fax:323-442-6338
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1373412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program