Provider Demographics
NPI:1851311849
Name:GORLICK, NEAL LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:LEWIS
Last Name:GORLICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5601 DE SOTO AVE
Mailing Address - Street 2:DEPARTMENT OF PLASTIC SURGERY
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6701
Mailing Address - Country:US
Mailing Address - Phone:818-719-3431
Mailing Address - Fax:818-719-4245
Practice Address - Street 1:5601 DE SOTO AVE
Practice Address - Street 2:DEPARTMENT OF PLASTIC SURGERY
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6701
Practice Address - Country:US
Practice Address - Phone:818-719-3431
Practice Address - Fax:818-719-4245
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG-840292082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G840290Medicaid
CA00G840290Medicaid