MEDICARE: DR. ALAGIRISWAMI VENKATESH 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
1	207RC0000X	Cardiovascular Disease Physician	A34195	CA

General Provider Information

NPI Number	:	1982654661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAGIRISWAMI VENKATESH M.D.

Provider Business Mailing Address
First Line	:	4521 SHERMAN OAKS AVE
Second Line	:	SUITE 1A
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-3807
Country	:	US
Telephone Number	:	818-784-8442
Fax Number	:	818-784-8642

Provider Business Practice Location Address
First Line	:	4521 SHERMAN OAKS AVE
Second Line	:	SUITE 1A
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-3807
Country	:	US
Telephone Number	:	818-784-8442
Fax Number	:	818-784-8642

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	10/13/2011

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