MEDICARE: DENIS SOLDATENKO RVT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471V0105X	Vascular Sonography Radiologic Technologist	ARDMS # 104997	MD

General Provider Information

NPI Number	:	1336487305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENIS SOLDATENKO RVT

Provider Business Mailing Address
First Line	:	1902 WESTWOOD BLVD
Second Line	:	207
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4670
Country	:	US
Telephone Number	:	310-401-1398
Fax Number	:

Provider Business Practice Location Address
First Line	:	1902 WESTWOOD BLVD
Second Line	:	207
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4670
Country	:	US
Telephone Number	:	310-401-1398
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2013
Last Update Date	:	03/01/2016

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Directions to “ DENIS SOLDATENKO RVT” Practice Location

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