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General NPI Number Information
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NPI Number | 1710939822
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Entity Type | Organization
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Legal Business Name | A.VENKATESH,M.D.,INC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 4521 SHERMAN OAKS AVE SUITE 1 B
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3807
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Country | US
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Telephone | 818-784-8442
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Fax | 818-784-8642
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Provider Business Mailing Address
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Address Line | 4521 SHERMAN OAKS AVE SUITE 1 B
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3807
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Country | US
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Telephone | 818-784-8442
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Fax | 818-784-8642
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAGIRISWAMI VENKATESH
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Credential | M.D.
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Telephone | 818-784-8442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | A39371
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A34195
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License Number State | CA
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