Healthcare Provider Details

I. General information

NPI: 1861944118
Provider Name (Legal Business Name): DAVID MORDECHAI GELMONT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4944 HOOD DR
WOODLAND HILLS CA
91364-4710
US

IV. Provider business mailing address

4944 HOOD DR
WOODLAND HILLS CA
91364-4710
US

V. Phone/Fax

Practice location:
  • Phone: 818-914-9628
  • Fax: 818-914-4332
Mailing address:
  • Phone: 818-914-9628
  • Fax: 818-914-4332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA034326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: