ENDEAVOR MEDICAL GROUP (NPI# 1528586096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528586096 |
| Entity Type | Organization |
| Organization Name | ENDEAVOR MEDICAL GROUP |
| Practice Address |
20246 Saticoy St Ste 201 Winnetka CA 91306-4433 |
| Mailing Address |
20246 Sitacoy Street Ste# 201 Winnetka CA 91306 |
| Practice Telephone | (818) 812-9506 |
| Practice Fax Number | 8188129508 |
| Mailing Telephone | 8188129506 |
| Mailing Fax Number | 8188129508 |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MR. TIMUR RUSLANOVICH POGODIN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8188129506 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
A133706 | CA | Ambulatory Health Care Facilities |
| Street Address |
20246 SATICOY ST STE 201 |
| City | WINNETKA |
| State | CA |
| Zip Code | 91306-4433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750855862 | Endeavors Practice Management, Inc. | Nurse Practitioner | 20246 Saticoy St Ste 201, Winnetka, CA 91306-4433 | 2019-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255856555 | California Physician Network LLC | Non-emergency Medical Transport (VAN) | 7657 Winnetka #712, Winnetka, CA 91306 | 2017-08-08 |
| 1073069373 | Mostafa Ahady | Optometrist | 7044 Oakdale Ave., Winnetka, CA 91306 | 2016-08-28 |
| 1922457340 | Evelin Garcia Psy.d. A Psychological Corporation | Community/Behavioral Health | 20832 Roscoe Blvd. Ste.202, Winnetka, CA 91306 | 2016-06-07 |
| 1104290485 | Edmond Reyhani | Pharmacist | 20839 W Roscoe Blvd, Winnetka, CA 91306 | 2015-11-24 |
| 1558730770 | Lester Antonio Marlin | Rehabilitation Practitioner | 20325 Sherman Way, Apt44, Winnetka, CA 91306 | 2015-09-17 |
| 1336578228 | Charmaine Fermin | Counselor | 20225 Cohasset St, Winnetka, CA 91306 | 2013-11-01 |
| 1669740429 | Robert Hazany | Dentist | 20832 Roscoe Blvd #101, Canoga Park, CA 91306 | 2011-12-08 |
| 1912223983 | Intrepid Anesthesia Associates Corporation | Anesthesiology | 427 W. Pueblo St., Santa Barbara, CA 91306 | 2010-04-15 |
| 1235315656 | Angelica Yerena | Marriage & Family Therapist | 20233 Lanark, Winnetka, CA 91306 | 2008-01-16 |
| 1205054434 | Winnetka Medical Group Inc | Family Medicine | 6742 Winnetka Ave, Winnetka, CA 91306 | 2007-04-23 |
| Find all providers in zip 91306 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 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.