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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207R00000X | Internal Medicine | G62711 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | STATE LICENSE | G62711 | 01 |
OLD GROUP IDENTIFIER # | ZZZ90227Z | 01 |
Other Name | Type Code |
---|---|
Robert K. Hanson M.D. | Former Legal Business Name - Organization |
Street Address |
22600 VENTURA BLVD. SUITE 104 |
City | WOODLAND HILLS |
State | CA |
Zip Code | 91364-1458 |
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 |
Find all providers in zip 91364 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
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. |
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 |
City | WOODLAND HILLS |
Zip Code | 91364 |
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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.