Healthcare Provider Details

I. General information

NPI: 1487968053
Provider Name (Legal Business Name): VOROBIOF MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ATLANTIC AVE MEMORIAL HEART & VASCULAR INSTITUTE
LONG BEACH CA
90806-1701
US

IV. Provider business mailing address

4245 BALCONY DRIVE
CALABASAS CA
91302
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-3371
  • Fax: 562-933-3372
Mailing address:
  • Phone:
  • Fax: 831-664-5018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA106608
License Number StateCA

VIII. Authorized Official

Name: DR. GABRIEL VOROBIOF
Title or Position: PRESIDENT
Credential: M.D.
Phone: 347-922-1278