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General NPI Number Information
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NPI Number | 1760544134
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Entity Type | Organization
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Legal Business Name | VALLEY GERIATRIC MEDICAL GROUP
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 12/23/2010
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Provider Practice Location Address
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Address Line | 4911 VAN NUYS BLVD SUITE 100
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1716
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Country | US
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Telephone | 818-986-7908
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Fax | 818-986-9308
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Provider Business Mailing Address
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Address Line | 4911 VAN NUYS BLVD SUITE 100
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1716
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Country | US
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Telephone | 818-986-7908
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Fax | 818-990-4662
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAN OSTERWEIL
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Credential | M.D.
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Telephone | 818-986-7908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | A41240
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License Number State | CA
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