EOLB MEDICAL GROUP INC NPI 1881165546

NPI Information

  • NPI: 1881165546
  • Provider Name: EOLB MEDICAL GROUP INC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 16927 VANOWEN ST STE 4
    LAKE BALBOA, CA
    ZIP 91406
  • Phone: (818) 483-4717

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NPI Details

EOLB MEDICAL GROUP INC is a general practice in Lake Balboa, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee EOLB MEDICAL GROUP INC NPI is 1881165546. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16927 VANOWEN ST STE 4
LAKE BALBOA, CA
ZIP 91406-582
Phone: (818) 483-4717

The provider's authorized official is Eugene Ostrovsky .
The authorized official title is President/ Medical Director and has the following contact phone number (818) 960-5334.

The enumeration date for this NPI number is 12/6/2018 and was last updated on 1/24/2019.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

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: 11/21/2025

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