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NPI Code Detail

MEDICARE: IZHR GOCONG LVN

MEDICARE: IZHR GOCONG LVN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse202474CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17346243588OTHERCAVETERANS AFFAIRS

General Provider Information

NPI Number : 1508457375
Entity Type Code : Individual
Provider Name (Legal Business Name) : IZHR GOCONG LVN
Provider Business Mailing Address
First Line : 4838 LAUREL CANYON BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91607-3717
Country : US
Telephone Number : 818-506-4455
Fax Number :
Provider Business Practice Location Address
First Line : 4838 LAUREL CANYON BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91607-3717
Country : US
Telephone Number : 818-506-4455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2021
Last Update Date : 07/11/2021

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Directions to “ IZHR GOCONG LVN” Practice Location

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