VICTOR LUIS MLECZKO (NPI# 1851741896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851741896 |
| Entity Type | Individual |
| Full Name | VICTOR LUIS MLECZKO |
| Credential | MD |
| Practice Address |
604 Rose Ave Venice CA 90291 |
| Mailing Address |
604 Rose Ave Venice CA 90291-2767 |
| Practice Telephone | 3103928636 |
| Mailing Telephone | 3103928636 |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2019-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A152130 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1851741896 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 Alhambra Ave, Martinez, CA 945533156 | 9253705200 |
| Street Address |
604 ROSE AVE |
| City | VENICE |
| State | CA |
| Zip Code | 90291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588655047 | Samantha Andrien Stewart | Psychiatry & Neurology | 604 Rose Ave, Venice, CA 90291-2767 | 2005-11-03 |
| 1740730050 | Kayla Sunhee Pang | Pharmacist | 604 Rose Ave, Venice, CA 90291-2767 | 2016-10-11 |
| 1568818227 | Meagan Wong | Family Medicine | 604 Rose Ave, Venice, CA 90291-2767 | 2016-05-11 |
| 1588027932 | Janet Chaidez | Nurse Practitioner | 604 Rose Ave, Venice, CA 90291 | 2016-04-03 |
| 1578926986 | Mimie Hoang Anh Tran | Family Medicine | 604 Rose Ave, Venice, CA 90291-2767 | 2016-04-02 |
| 1245695006 | Bridget Kelleher | Nurse Practitioner | 604 Rose Ave, Venice, CA 90291-2767 | 2015-12-22 |
| 1619341773 | Kristin Grannis | Marriage & Family Therapist | 604 Rose Ave, Venice, CA 90291-2767 | 2015-11-30 |
| 1730558842 | Ivy Doris Chang | Social Worker | 604 Rose Ave, Venice, CA 90291-2767 | 2015-09-18 |
| 1265808547 | Danielle Sinkford | Registered Nurse | 604 Rose Ave, Venice, CA 90291-2767 | 2015-08-20 |
| 1033596143 | Alexander Pappas | Family Medicine | 604 Rose Ave, Venice, CA 90291-2767 | 2015-04-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033629837 | Dylan Booth | Dentist | 601 Vernon Ave, Venice, CA 90291 | 2017-10-05 |
| 1467979500 | Linda Sittler | Registered Nurse | 1025 Palms Ave, Venice, CA 90291 | 2017-08-29 |
| 1003218660 | Patricia Guadalupe Rivas | Counselor | 717 Lincoln Blvd., Venice, CA 90291 | 2014-09-25 |
| 1497016877 | Carrie Lynn Kowalski | Physician Assistant | 604 Rose Avenue, Venice, CA 90291 | 2012-06-02 |
| 1821364761 | Cheryl Lynn Perkins | Nutritionist | 215 Culver Boulevard, # 5203, Playa Del Rey, CA 90291 | 2012-03-26 |
| 1629391875 | James L. Hoff | Optometrist | 1636 Abbot Kinney Blvd., Venice, CA 90291 | 2010-03-02 |
| 1720315096 | Kristen Nicol Leishman | Counselor | 911 Coeur D'alene Ave, Venice, CA 90291 | 2009-11-06 |
| 1922237882 | David Anthony Garcia | Physician Assistant | 15031 Rinaldi St., Providence Holy Cross Medical Center Ed, Mission Hills, CA 90291 | 2009-07-13 |
| 1548411010 | David Watts | Acupuncturist | 307 S. Robertson Blvd, Beverly Hills, CA 90291 | 2008-10-02 |
| 1184891699 | Judy Alexander | Voluntary or Charitable | 204 Hampton Drive, St Joseph Center, Venice, CA 90291 | 2008-05-14 |
| Find all providers in zip 90291 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568060473 | Rhc Venice LLC | Family Medicine | 333 Tamiami Trl S Ste 203, Venice, FL 34285-2424 | 2020-10-13 |
| 1679123111 | Emily Kathleen Presmanes | Family Medicine | 248 Ruth Ave, Venice, CA 90291-2712 | 2019-09-17 |
| 1316461486 | Dr Gibertinis Home Care Pllc | Family Medicine | 3048 Grey Heron Cir, Venice, FL 34293-1404 | 2017-08-01 |
| 1457883381 | Sophia Gail Ciaravino | Family Medicine | 2446 Laurel Rd, Venice, FL 34275-3204 | 2017-03-30 |
| 1679937965 | Good Business LLC | Family Medicine | 808 E Venice Ave, Venice, FL 34285-7039 | 2016-04-12 |
| 1033570809 | Dr. Ralph H. Rusco Jr. | Family Medicine | 807 Us Highway 41 Byp S, Venice, FL 34285-4360 | 2016-03-08 |
| 1780018564 | William Stuart Weil | Family Medicine | 1825 Ocean Front Walk, Venice, CA 90290 | 2013-08-28 |
| 1346426632 | Gill Family Medicine Pl | Family Medicine | 425 Commercial Ct Ste 112, Venice, FL 34292-1642 | 2008-01-16 |
| 1215038856 | Coley M King | Family Medicine | 604 Rosse Ave., Venice, CA 90291 | 2006-09-26 |
| 1326144833 | Rick Simovitz | Family Medicine | 722 The Rialto, Venice, FL 34285-3524 | 2006-09-15 |
| Find all providers in VENICE | ||||
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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.