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General NPI Number Information
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NPI Number | 1396835831
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Entity Type | Individual
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Provider Name | VICTOR DORODNY MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 30765 PACIFIC COAST HWY # 285
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City | MALIBU
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State | CA
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Zip | 90265-3646
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Country | US
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Telephone | 828-367-6369
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Fax | 310-457-7383
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Provider Business Mailing Address
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Address Line | 30765 PACIFIC COAST HWY # 285
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City | MALIBU
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State | CA
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Zip | 90265-3646
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Country | US
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Telephone | 828-367-6369
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Fax | 310-457-7383
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A35905
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License Number State | CA
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