Provider Demographics
NPI:1801628425
Name:DONLAN MEDICAL CORP
Entity type:Organization
Organization Name:DONLAN MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-317-9391
Mailing Address - Street 1:150 N ROBERTSON BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2121
Mailing Address - Country:US
Mailing Address - Phone:424-317-9391
Mailing Address - Fax:424-267-2666
Practice Address - Street 1:150 N ROBERTSON BLVD STE 115
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2121
Practice Address - Country:US
Practice Address - Phone:424-317-9391
Practice Address - Fax:424-267-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty