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General NPI Number Information
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NPI Number | 1598903783
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Entity Type | Organization
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Legal Business Name | DR DORODNY INC
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Dates
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Enumeration Date | 01/27/2009
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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 SUITE 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 SUITE 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 | PRESIDENT
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Name | DR. VICTOR S DORODNY
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Credential | MD, ND, PHD, MPH
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Telephone | 828-367-6369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number | A35905
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A350905
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License Number State | CA
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | A35905
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A35905
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License Number State | CA
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