Provider Demographics
NPI:1356633978
Name:DENNIS R. HOLMES, MD, INC
Entity type:Organization
Organization Name:DENNIS R. HOLMES, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-742-5784
Mailing Address - Street 1:5670 WILSHIRE BLVD STE 1740
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5656
Mailing Address - Country:US
Mailing Address - Phone:714-522-2001
Mailing Address - Fax:714-522-7503
Practice Address - Street 1:1513 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3021
Practice Address - Country:US
Practice Address - Phone:213-742-5784
Practice Address - Fax:213-742-6055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-15
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68940208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty