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General NPI Number Information
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NPI Number | 1174624944
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Entity Type | Organization
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Legal Business Name | MS VAISMAN MEDICAL SERVICES A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 11724 VENTURA BLVD SUITE A
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City | STUDIO CITY
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State | CA
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Zip | 91604
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Country | US
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Telephone | 818-506-6937
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Fax | 818-506-2594
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Provider Business Mailing Address
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Address Line | 11724 VENTURA BLVD SUITE A
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City | STUDIO CITY
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State | CA
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Zip | 91604
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Country | US
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Telephone | 818-506-6937
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Fax | 818-506-2594
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. MARK VAISMAN
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Credential | MD
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Telephone | 818-506-6937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A38899
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2278P1004X
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Taxonomy Name | Pulmonary Diagnostics Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A38899
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License Number State | CA
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