Healthcare Provider Details

I. General information

NPI: 1780105692
Provider Name (Legal Business Name): VLADIMIR JANVELIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 HOLLISTER AVE
GOLETA CA
93117-2583
US

IV. Provider business mailing address

7406 HOLLISTER AVE
GOLETA CA
93117-2583
US

V. Phone/Fax

Practice location:
  • Phone: 800-835-2362
  • Fax:
Mailing address:
  • Phone: 800-835-2362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA166669
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: