Provider Demographics
NPI:1689071946
Name:CURTIS F. VEAL, MD, INC
Entity Type:Organization
Organization Name:CURTIS F. VEAL, MD, INC
Other - Org Name:WESTSIDE WALK-IN CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:VEAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:206-696-2897
Mailing Address - Street 1:1720 PENMAR AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-2940
Mailing Address - Country:US
Mailing Address - Phone:206-696-2897
Mailing Address - Fax:
Practice Address - Street 1:3019 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5548
Practice Address - Country:US
Practice Address - Phone:206-696-2897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89346207R00000X
CAPA21928363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty