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NPI Code Detail

MEDICARE: DR. POLINA VOLODARSKAYA DO

MEDICARE: DR. POLINA VOLODARSKAYA DO
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
1207Q00000XFamily Medicine Physician20A13732CA
2207R00000XInternal Medicine Physician13732CA
3207R00000XInternal Medicine Physician20A13732CA

General Provider Information

NPI Number : 1700851896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. POLINA VOLODARSKAYA DO
Provider Business Mailing Address
First Line : 625 FAIR OAKS AVE., #270
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-5801
Country : US
Telephone Number : 626-346-2455
Fax Number : 209-368-2885
Provider Business Practice Location Address
First Line : 7777 SUNRISE BLVD. #2500
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 98610-2372
Country : US
Telephone Number : 916-722-2227
Fax Number : 877-860-5422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 10/22/2018

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Directions to “ DR. POLINA VOLODARSKAYA DO” Practice Location

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