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EMMETT BERG DO INC. AND HOLVEY MEDICAL GROUP INC. NPI 1194850446


NPI Information

NPI: 1194850446
Provider Name: EMMETT BERG DO INC. AND HOLVEY MEDICAL GROUP INC.

Doing Business As: HEALTHLINE MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0693597

Address:
15211 VANOWEN ST
SUITE 105
VAN NUYS, CA
ZIP 91405
Phone: (818) 997-7711
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EMMETT BERG DO INC. AND HOLVEY MEDICAL GROUP INC. is a family medicine in Van Nuys, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EMMETT BERG DO INC. AND HOLVEY MEDICAL GROUP INC. NPI is 1194850446. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Healthline Medical Group.

The provider's business location address is:

15211 VANOWEN ST
SUITE 105
VAN NUYS, CA
ZIP 91405-606
Phone: (818) 997-7711
Fax: (818) 997-3744

The provider's authorized official is Rita Gaudioso .
The authorized official title is Administrator and has the following contact phone number (818) 997-7711.

The CLIA number assigned to this NPI record is 05D0693597 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/23/2007 and was last updated on 8/22/2020.


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
1207Q00000XFamily MedicineYes
2207R00000XInternal MedicineX

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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