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TARZANA PEDIATRIC MEDICAL GROUP INC NPI 1033227970


NPI Information

NPI: 1033227970
Provider Name: TARZANA PEDIATRIC MEDICAL GROUP INC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D0559321

Address:
18370 BURBANK BLVD
SUITE #204
TARZANA, CA
ZIP 91356
Phone: (818) 345-7792
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TARZANA PEDIATRIC MEDICAL GROUP INC is a pediatrics in Tarzana, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. TARZANA PEDIATRIC MEDICAL GROUP INC NPI is 1033227970. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

18370 BURBANK BLVD
SUITE #204
TARZANA, CA
ZIP 91356-851
Phone: (818) 345-7792
Fax: (818) 345-9052

The provider's authorized official is Norman Lavin .
The authorized official title is Owner and has the following contact phone number (818) 345-7792.

The CLIA number assigned to this NPI record is 05D0559321 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 8/12/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismG16804CALIFORNIANo
2208000000XPediatricsG16804CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G16804OTHERCALIFORNIASTATE LICENSE
2GR0002970MEDICAIDCALIFORNIA
3W7748MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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