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BOULEVARD PEDIATRICS MEDICAL GROUP INC NPI 1669509154


NPI Information

NPI: 1669509154
Provider Name: BOULEVARD PEDIATRICS MEDICAL GROUP INC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D1014120

Address:
16550 VENTURA BLVD
STE 414
ENCINO, CA
ZIP 91436
Phone: (818) 783-3110
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BOULEVARD PEDIATRICS MEDICAL GROUP INC is a pediatrics in Encino, 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. BOULEVARD PEDIATRICS MEDICAL GROUP INC NPI is 1669509154. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16550 VENTURA BLVD
STE 414
ENCINO, CA
ZIP 91436-004
Phone: (818) 783-3110
Fax: (818) 783-3115

The provider's authorized official is Jeremy F Shapiro .
The authorized official title is President and has the following contact phone number (818) 783-3110.

The CLIA number assigned to this NPI record is 05D1014120 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 1/22/2014.


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
1208000000XPediatricsA81091CALIFORNIAYes

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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