Healthcare Provider Details

I. General information

NPI: 1104732858
Provider Name (Legal Business Name): NORTHCARE MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6450 BELLINGHAM AVE
NORTH HOLLYWOOD CA
91606-1402
US

IV. Provider business mailing address

6450 BELLINGHAM AVE
NORTH HOLLYWOOD CA
91606-1402
US

V. Phone/Fax

Practice location:
  • Phone: 818-821-1515
  • Fax: 818-821-1517
Mailing address:
  • Phone: 818-821-1515
  • Fax: 818-821-1517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM LEE MATZNER
Title or Position: PRESIDENT / MD
Credential:
Phone: 818-821-1515