Healthcare Provider Details

I. General information

NPI: 1164464780
Provider Name (Legal Business Name): VICTORIA LYNN SZATALOWICZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E HARDY ST
INGLEWOOD CA
90301-4011
US

IV. Provider business mailing address

P.O. BOX 622
CULVER CITY CA
90232-0622
US

V. Phone/Fax

Practice location:
  • Phone: 310-419-8636
  • Fax: 310-963-0403
Mailing address:
  • Phone: 310-419-8693
  • Fax: 310-836-0592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC39183
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: