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NPI Code Detail

MEDICARE: DR. VADIM CHUDNOVSKY M.D.

MEDICARE: DR. VADIM CHUDNOVSKY M.D.
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
12085R0202XDiagnostic Radiology PhysicianA48658CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922049394
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VADIM CHUDNOVSKY M.D.
Provider Business Mailing Address
First Line : 816 W ACEQUIA AVE
Second Line :
City : VISALIA
State : CA
Zip : 93291-6126
Country : US
Telephone Number : 559-627-6363
Fax Number :
Provider Business Practice Location Address
First Line : 2601 E CHAPMAN AVE
Second Line :
City : ORANGE
State : CA
Zip : 92869-3206
Country : US
Telephone Number : 714-633-0011
Fax Number : 714-835-3287
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 12/26/2017

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