Healthcare Provider Details

I. General information

NPI: 1558278036
Provider Name (Legal Business Name): VITALSTEM INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14332 VENTURA BLVD
SHERMAN OAKS CA
91423-2717
US

IV. Provider business mailing address

14332 VENTURA BLVD
SHERMAN OAKS CA
91423-2717
US

V. Phone/Fax

Practice location:
  • Phone: 818-581-2001
  • Fax:
Mailing address:
  • Phone: 818-581-2001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: NAVEED NATANZI
Title or Position: OWNER
Credential: DO
Phone: 818-581-2001