Basic Information
| Provider Information | |||||||||
| NPI: | 1568812436 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | IBN ESSAYED | ||||||||
| FirstName: | WALID | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 FRANCIS STREET | ||||||||
| Address2: | BWH,NEUROLOGICAL SURGERY RESIDENCY | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177328719 | ||||||||
| FaxNumber: | 6172646835 | ||||||||
| Practice Location | |||||||||
| Address1: | 525 S OXFORD AVE APT 113 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900204219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3477452966 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2016 | ||||||||
| LastUpdateDate: | 07/11/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 267119 | MA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.