05D0546595 CLIA NUMBER - STEFAN A UNTERHALTER, MD

Laboratory Demographics

CLIA Number: 05D0546595

Facility Name: STEFAN A UNTERHALTER, MD

Facility Address:
9001 WILSHIRE BLVD STE #201
BEVERLY HILLS, CA
ZIP 90211
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Facility Phone Number: 310 274-2722

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619023249

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	05D0546595
LAB Type	Physician Office
Facility Name	STEFAN A UNTERHALTER, MD
Street	9001 WILSHIRE BLVD STE #201
City	BEVERLY HILLS
State	CA
ZIP	90211
Phone	310 274-2722
CertificateType	4
CertificateEffectiveDate	10/13/2023
CertificateExpirationDate	10/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024