Healthcare Provider Details

I. General information

NPI: 1740641257
Provider Name (Legal Business Name): URGENT ORTHOPAEDIC CARE MULTI SPECIALTY MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14435 HAMLIN ST UNITE B
VAN NUYS CA
91401-6205
US

IV. Provider business mailing address

14435 HAMLIN ST UNITE B
VAN NUYS CA
91401-6205
US

V. Phone/Fax

Practice location:
  • Phone: 818-616-5533
  • Fax: 818-264-0812
Mailing address:
  • Phone: 818-616-5533
  • Fax: 818-264-0812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. VLAD GENDELMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 818-344-6784