PRIVATE MEDICAL GROUP


Address: 22600 Ventura Blvd., Suite 104, Woodland Hills, CA 91364-1458
Phone: 8182251617

PRIVATE MEDICAL GROUP (NPI# 1710104369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1710104369
Entity Type Organization
Organization Name PRIVATE MEDICAL GROUP
Other Organization Name ROBERT K. HANSON M.D.
Practice Address 22600 Ventura Blvd.
Suite 104
Woodland Hills
CA 91364-1458
Practice Telephone 8182251617
Practice Fax Number 8182251620
Mailing Telephone 8182251617
Mailing Fax Number 8182251620
Enumeration Date 2007-04-18
Last Update Date 2020-08-22
Authorized Official Name ROBERT KEVIN HANSON (OWNER)
Authorized Official Telephone 8182251617
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine G62711 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA STATE LICENSE G62711 01
OLD GROUP IDENTIFIER # ZZZ90227Z 01

Other Provider/Organization Names

Other Name Type Code
Robert K. Hanson M.D. Former Legal Business Name - Organization

Office Location

Street Address 22600 VENTURA BLVD.
SUITE 104
City WOODLAND HILLS
State CA
Zip Code 91364-1458

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316574890 Woodland Hills Cardiology Group, PC Internal Medicine Woodland Hills Cardiology Group, PC, 22900 Ventura Blvd, Ste 165, Woodland Hills, CA 91364 2020-03-25
1952940967 Creative Care, Inc. Substance Abuse Rehabilitation Facility 5311 Topanga Canyon Blvd, Suites 203 & 207, Woodland Hills, CA 91364 2019-12-23
1629544531 Jessica Sarah Anishban Marriage & Family Therapist 22935 Ventura Blvd Ste 212, Woodland Hills, CA 91364 2018-10-17
1194249128 Katia Siri Acupuncturist 4830 Winnetka Avenue, Woodland Hills, CA 91364 2017-08-01
1457881070 Navid Messian Marriage & Family Therapist 5308 Penfield Ave., Woodland Hills, CA 91364 2017-06-15
1801330766 Samantha Meghann Mathew Behavioral Analyst 20259 Ventura Blvd Ste 259a, Woodland Hills, CA 91364 2016-12-12
1356793947 Evolve Growth Initiatives, LLC Clinic/Center 4810 Azucena Rd, Woodland Hills, CA 91364 2016-07-07
1538516976 Chris Massman Marriage & Family Therapist 5242 Darro Road, Woodland Hills, CA 91364 2016-05-16
1588065874 Morrice Barkers Apprey Marriage & Family Therapist 21031 Ventura Blvd., #704, Woodland Hills, CA 91364 2014-09-06
1144640723 Kenneth Gustafson Physical Therapy Assistant 23888 Mulholland Drive, Ms # 270, Woodland Hills, CA 91364 2014-04-22
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053855486 Kirti Talole Md Inc Internal Medicine 6301 Glade Ave, K213, Woodland Hills, CA 91367-1939 2016-12-04
1861944118 David Mordechai Gelmont Internal Medicine 4944 Hood Dr, Woodland Hills, CA 91364-4710 2016-11-02
1295174860 Igor Gary Shlifer Internal Medicine 20301 Ventura Blvd Ste 210, Woodland Hills, CA 91364-0934 2013-06-17
1922358308 Ellen Bierley Masse Internal Medicine 20511 Wells Dr, Woodland Hills, CA 91364-3433 2012-09-13
1326328444 Robert James Jaffe Internal Medicine 22139 Burbank Blvd Unit 5, Woodland Hills, CA 91367-6224 2011-08-20
1821318312 Yu-hsiang Lin Internal Medicine 6344 Topanga Canyon Blvd, Ste 2040, Woodland Hills, CA 91367 2010-06-07
1790911592 Alexander Houngjinn Cho Internal Medicine 5601 De Soto Ave Dept Of, Woodland Hills, CA 91367 2009-06-08
1154521730 Parichehr Angela Tabibian Internal Medicine 20315 Ventura Blvd Ste 315a, Woodland Hills, CA 91364-2449 2007-07-20
1821162736 Anthony A Nguyen Internal Medicine 21555 Oxnard St, Suite 6g, Woodland Hills, CA 91367-4943 2006-11-20
1679656946 Allan Lee Kurtz Internal Medicine 6325 Topanga Canyon Blvd Ste 501, Woodland Hills, CA 91367-2052 2006-10-23
Find all providers in WOODLAND HILLS

Competitor

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City WOODLAND HILLS
Zip Code 91364

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Dataset Information

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.

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