Healthcare Provider Details

I. General information

NPI: 1083986848
Provider Name (Legal Business Name): VALLEY HEART AND RHYTHM MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18411 CLARK ST STE 102
TARZANA CA
91356-3524
US

IV. Provider business mailing address

12612 CUMPSTON ST
VALLEY VILLAGE CA
91607-1914
US

V. Phone/Fax

Practice location:
  • Phone: 818-724-8000
  • Fax: 818-583-6506
Mailing address:
  • Phone: 818-583-7223
  • Fax: 818-904-5896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA114088
License Number StateCA

VIII. Authorized Official

Name: MENACHEM WAKSLAK
Title or Position: OWNER
Credential: M.D.
Phone: 818-583-7223