Healthcare Provider Details

I. General information

NPI: 1144731092
Provider Name (Legal Business Name): UNIVERSAL CARE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10866 RIVERSIDE DR # 300
NORTH HOLLYWOOD CA
91602-2236
US

IV. Provider business mailing address

10061 RIVERSIDE DR # 782
TOLUCA LAKE CA
91602-2560
US

V. Phone/Fax

Practice location:
  • Phone: 661-496-2411
  • Fax: 818-980-8301
Mailing address:
  • Phone: 661-496-2411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CATALINO DUREZA
Title or Position: SURGEON
Credential: MD
Phone: 661-496-2411