| Tarzana Endocrine & Medical Group | |
|
18370 Burbank Blvd Ste 601 Tarzana CA 91356-2831 | |
| (818) 996-5700 | |
| (818) 996-1649 |
| Full Name | Tarzana Endocrine & Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 18370 Burbank Blvd, Tarzana, California |
| Authorized Official Name and Position | Gary Tanouye (PRESIDENT) |
| Authorized Official Contact | 8189965700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tarzana Endocrine & Medical Group 18370 Burbank Blvd Ste 601 Tarzana CA 91356-2831 Ph: (818) 996-5700 | Tarzana Endocrine & Medical Group 18370 Burbank Blvd Ste 601 Tarzana CA 91356-2831 Ph: (818) 996-5700 |
| NPI Number | 1205831583 |
|---|---|
| Provider Enumeration Date | 06/14/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205831583 | NPI | - | NPPES |
| 19-139 | Other | CA | DHS MEDICAL WASTE REG # |
| FAC00002669 | Other | CA | RADIATION MACHINE DEPT OF PUBLIC HEALTH, CALIF. |
| T0796 | Other | CA | RAILROAD GROUP NUMBER |
| 05D0559244 | Other | CA | CLIA LICENSE STE 300 |
| 19359 | Other | CA | FICTITIOUS NAME PERMIT |
| 110061982 | Other | CA | RAILROAD GROUP RENDERING |
| YYY40048Y | Other | CA | BLUE SHIELD OF CALIFORNIA |
| CAL000056694 | Other | CA | RADIOLOGIC LICENSE |
| CLF298 | Other | CA | STATE LABORATORY LICENSE |
| CPP 315971 | Other | CA | STATE LABORATORY LICENSE SUITE 601 |
| YYY40048Y | Medicaid | CA | |
| 05D0889138 | Other | CA | CLIA LICENSE STE 601 |
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› Verified 3 days ago
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