Healthcare Provider Details

I. General information

NPI: 1851215768
Provider Name (Legal Business Name): LUXEMED CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 BURBANK BLVD UNIT 4
NORTH HOLLYWOOD CA
91601-2513
US

IV. Provider business mailing address

10700 BURBANK BLVD UNIT 4
NORTH HOLLYWOOD CA
91601-2513
US

V. Phone/Fax

Practice location:
  • Phone: 818-747-2038
  • Fax:
Mailing address:
  • Phone: 818-747-2038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: VENKATA SR PULAKANTI
Title or Position: CEO /OWNER
Credential: MD
Phone: 818-747-2038