SAMUEL LEIBOVICI (NPI# 1063585164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063585164 |
| Entity Type | Individual |
| Full Name | SAMUEL LEIBOVICI |
| Credential | M.D. |
| Practice Address |
18250 Roscoe Blvd Ste 200 Northridge CA 91325-4226 |
| Mailing Address |
421 Van Wyck Mews Norfolk VA 23517-2129 |
| Practice Telephone | 8187214800 |
| Mailing Telephone | 7573738438 |
| Mailing Fax Number | 7573337736 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 0101237467 | VA | Other Service Providers |
| N | 207P00000X | Emergency Medicine | 0101237467 | VA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | C55251 | CA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 0101237467 | VA | Allopathic & Osteopathic Physicians |
| N | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
61-19200 | CA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 0101237467 | VA | Allopathic & Osteopathic Physicians |
| Y | 2083A0300X | 61-19200 | CA |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | INTERNAL MEDICINE | C55251 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 421 Van Wyck Mews, Norfolk, VA 23517 | 7573738438 | 7573337736 |
| Street Address |
18250 ROSCOE BLVD STE 200 |
| City | NORTHRIDGE |
| State | CA |
| Zip Code | 91325-4226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821516535 | Katherine Guardado | Nurse Practitioner | 18250 Roscoe Blvd Ste 200, Northridge, CA 91325 | 2017-09-01 |
| 1457723918 | Allison Stiller | Registered Nurse | 18250 Roscoe Blvd Ste 200, Northridge, CA 91325-4226 | 2015-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346961 | Patricia Yamilet Morales | Registered Nurse | 18300 Roscoe Blvd Dignity Health- Northridge Hospital M, Northridge, CA 91325 | 2020-11-02 |
| 1790342897 | Northridge Kidney Center, LLC | Clinic/Center | 17710 Roscoe Blvd, Northridge, CA 91325 | 2019-05-23 |
| 1063078376 | Ozlem Alper | Student in an Organized Health Care Education/Training Program | 18497 Dearborn St, Unit 112, Northridge, CA 91325 | 2019-05-13 |
| 1144883489 | Better Sober | Clinic/Center | 9339 Louse Ave, Northridge, CA 91325 | 2019-04-22 |
| 1902383920 | Ntr Resources, LLC | Pathology | 17433 Nordhoff, Northridge, CA 91325 | 2018-07-23 |
| 1043713969 | Poly-med Pharmacy Inc | Pharmacy | 17313 Roscoe Blvd, Northridge, CA 91325 | 2018-03-16 |
| 1982151940 | Maria Dakessian | Dentist | 18250 Roscoe Blvd Ste 345, Northridge, CA 91325 | 2016-09-07 |
| 1487019469 | Beshoy Gerges | Pharmacist | 8254 White Oak Ave Unit 4, Northridge, CA 91325 | 2015-12-17 |
| 1235520305 | Gema Bautista | Social Worker | 8550 Balboa Blvd Ste 216, Northridge, CA 91325 | 2015-02-11 |
| 1083018873 | Sosann Haider | Pharmacist | 18444 Plummer St., Northridge, CA 91325 | 2014-10-22 |
| Find all providers in zip 91325 | ||||
| City | NORTHRIDGE |
| Zip Code | 91325 |
Please comment or provide details below to improve the information on SAMUEL LEIBOVICI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.