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NPI Code Detail

MEDICARE: VIKTOR VAKULENKO MD

MEDICARE: VIKTOR VAKULENKO MD
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
1207L00000XAnesthesiology PhysicianC52155CA

General Provider Information

NPI Number : 1629054549
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIKTOR VAKULENKO MD
Provider Business Mailing Address
First Line : 15910 VENTURA BLVD
Second Line : SUITE 1502
City : ENCINO
State : CA
Zip : 91436-2802
Country : US
Telephone Number : 818-728-9877
Fax Number :
Provider Business Practice Location Address
First Line : 15910 VENTURA BLVD
Second Line : SUITE 1502
City : ENCINO
State : CA
Zip : 91436-2802
Country : US
Telephone Number : 818-728-9877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 03/25/2014

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Directions to “ VIKTOR VAKULENKO MD” Practice Location

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