MEDICARE: NATHAN VENGALIL MD, A PROFESSIONAL CORPORATION

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
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1740088681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATHAN VENGALIL MD, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	818 N DOHENY DR APT 307
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-4857
Country	:	US
Telephone Number	:	313-806-2476
Fax Number	:

Provider Business Practice Location Address
First Line	:	818 N DOHENY DR APT 307
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-4857
Country	:	US
Telephone Number	:	313-806-2476
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NATHAN VENGALIL
Credential	:	MD
Telephone Number	:	313-806-2476

Provider Enumeration Date	:	03/06/2025
Last Update Date	:	03/06/2025

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1104579093 — AXEDIA
Practice Location Address:

818 N DOHENY DR APT 206
WEST HOLLYWOOD, CA
90069-4857

Practice Phone: 323-683-2040
Practice Fax:

1538292008 — CHARLIE J WARE JR. LMT, DOM
Practice Location Address:

2632 HOLLYWOOD BLVD , SUITE 300
HOLLYWOOD, FL
33020-4857

Practice Phone: 305-498-4483
Practice Fax: 954-458-5990

1174924955 — DR. CHARLIE WARE AP, LLC
Practice Location Address:

2632 HOLLYWOOD BLVD , SUITE 300
HOLLYWOOD, FL
33020-4857

Practice Phone: 954-458-5999
Practice Fax: 954-458-5990

1538538806 — MRS. JACQUELINE G MCCUE LCSW
Practice Location Address:

2632 HOLLYWOOD BLVD STE 304
HOLLYWOOD, FL
33020-4857

Practice Phone: 954-761-9333
Practice Fax:

1629760921 — ARIEL BORGES DUANES
Practice Location Address:

6355 SW 8TH ST APT 607
WEST MIAMI, FL
33144-4857

Practice Phone: 786-678-2836
Practice Fax:

Directions to “NATHAN VENGALIL MD, A PROFESSIONAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.