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General NPI Number Information
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NPI Number | 1295810323
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Entity Type | Organization
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Legal Business Name | SAN FERNANDO VALLEY GASTROENTEROLOGY MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 18425 BURBANK BLVD STE 500
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City | TARZANA
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State | CA
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Zip | 91356-6691
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Country | US
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Telephone | 818-708-6000
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Fax | 818-708-6009
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Provider Business Mailing Address
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Address Line | 18425 BURBANK BLVD STE 500
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City | TARZANA
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State | CA
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Zip | 91356-6691
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Country | US
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Telephone | 818-708-6000
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Fax | 818-708-6009
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JUDY FELKAI
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Credential |
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Telephone | 818-708-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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