| Lutz E Ventzke Md A Medical Corporation | |
|
7320 Woodlake Ave Suite 210 West Hills CA 91307-1483 | |
| (818) 348-3230 | |
| (818) 883-4496 |
| Full Name | Lutz E Ventzke Md A Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 7320 Woodlake Ave, West Hills, California |
| Authorized Official Name and Position | Lutz Eberhard Ventzke (PRESIDENT LUTZ E VENTZKE MD A MEDIC) |
| Authorized Official Contact | 8187047248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutz E Ventzke Md A Medical Corporation 22357 Mulholland Drive Woodland Hills CA 91364-4934 Ph: (818) 704-7248 | Lutz E Ventzke Md A Medical Corporation 7320 Woodlake Ave Suite 210 West Hills CA 91307-1483 Ph: (818) 348-3230 |
| NPI Number | 1558581702 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 04/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558581702 | NPI | - | NPPES |
| 00A178870 | Medicaid | CA | |
| 05D0714631 | Other | CLIA NUMBER | |
| WA17887A | Other | PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A17887 (California) | Primary |
| 207RG0100X | Internal Medicine - Gastroenterology | A17887 (California) | Secondary |
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