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General NPI Number Information
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NPI Number | 1083986848
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Entity Type | Organization
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Legal Business Name | VALLEY RHYTHM MEDICAL PRACTICE
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 16119 VANOWEN ST
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City | VAN NUYS
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State | CA
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Zip | 91406-4822
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Country | US
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Telephone | 818-583-7223
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Fax | 818-904-5896
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Provider Business Mailing Address
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Address Line | 16119 VANOWEN ST
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City | VAN NUYS
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State | CA
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Zip | 91406-4822
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Country | US
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Telephone | 818-583-7223
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Fax | 818-904-5896
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Authorized Official
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Title or Position | OWNER
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Name | MENACHEM WAKSLAK
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Credential | M.D.
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Telephone | 818-583-7223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | A114088
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License Number State | CA
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