IndividualActive
Agnes Wallbom, M.D., M.S.
NPI 1316976509 · Physical Medicine & Rehabilitation Physician · Los Angeles, CA
Provider details
- NPI number
- 1316976509
- Entity type
- Individual
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D., M.S.
- Sex
- Female
- Sole proprietor
- No
- License
- G078095 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
11301 Wilshire Blvd # 117
Glavahs Dept Pm&r
Los Angeles, CA 90073-1003
Phone: (310) 478-3711
Fax: (310) 268-4935
Approximate (ZIP-level) locationGet directions
Mailing address
11301 Wilshire Blvd # 117
Los Angeles, CA 90073-1003
Registry dates
- Enumerated
- 2006-07-01
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.