| Tarzana Valley Vita Medical Center | |
|
18607 Ventura Blvd., Suite 206 Tarzana CA 91356-4144 | |
| (818) 758-8282 | |
| (818) 758-8286 |
| Full Name | Tarzana Valley Vita Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 18607 Ventura Blvd.,, Tarzana, California |
| Authorized Official Name and Position | Yuzef Gurovich (OWNER/CEO) |
| Authorized Official Contact | 8059100333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tarzana Valley Vita Medical Center 18607 Ventura Blvd., Suite 206 Tarzana CA 91356-4144 Ph: (818) 758-8282 | Tarzana Valley Vita Medical Center 18607 Ventura Blvd., Suite 206 Tarzana CA 91356-4144 Ph: (818) 758-8282 |
| NPI Number | 1003857434 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 04/29/2014 |
| Medicare PECOS PAC ID | 1658285911 |
|---|---|
| Medicare Enrollment ID | O20031119000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003857434 | NPI | - | NPPES |
| GR0090900 | Medicaid | CA | |
| ZZZ02527Z | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Zinovy N Lekht |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427093236 PECOS PAC ID: 1052218997 Enrollment ID: I20031217001011 |
| Provider Name | Khanh Ngoc Tuan Duong |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1295754125 PECOS PAC ID: 8527959436 Enrollment ID: I20040322000912 |
| Provider Name | Arkady Stern |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033198882 PECOS PAC ID: 6507961513 Enrollment ID: I20070419000742 |
| Provider Name | Dmitriy Romanenko |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881894715 PECOS PAC ID: 6406925114 Enrollment ID: I20080521000517 |
| Provider Name | Sedi Hadadian |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326295452 PECOS PAC ID: 6103966460 Enrollment ID: I20091217000018 |
Neil D. Fagen,m.d.,inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18411 Clark St, 204, Tarzana, CA 91356 Phone: 818-996-4796 Fax: 818-996-4793 | |
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