Vernon H Lackman (NPI# 1174554646, PAC ID# 4183514904) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1174554646 |
| PAC ID by PECOS | 4183514904 |
| Professional Enrollment ID | I20040316001464 |
| Full Name | Vernon H Lackman |
| Organization Legal Name | FACEY MEDICAL FOUNDATION |
| Address |
17909 Soledad Canyon Rd Suite 100 Canyon Country CA 91387-3210 |
| Phone Number | 6612505200 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, UCLA SCHOOL OF MEDICINE |
| Graduation Year | 1988 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 3173436276 |
| Number of Group Practice Members | 222 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050278 | PROVIDENCE HOLY CROSS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 17909 Soledad Canyon Rd, Suite 100, Canyon Country, CA 91387-3210 | 6612505200 | FACEY MEDICAL FOUNDATION |
| Organization Legal Name | FACEY MEDICAL FOUNDATION |
| Physicians | 255 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarthi Rakshen Shah | Internal Medicine | Facey Medical Foundation | 11333 Sepulveda Blvd, Mission Hills, CA 91345-1115 |
| Jan B Janay | Family Medicine | Facey Medical Foundation | 26357 Mcbean Pkwy, Suite 320, Valencia, CA 91355-4488 |
| Maeve Lin | Family Medicine | Facey Medical Foundation | 2655 1st St, Suite 325, Simi Valley, CA 93065-1581 |
| Tri D Dao | Family Medicine | Facey Medical Foundation | 191 S Buena Vista St, Suite 100, Burbank, CA 91505-4562 |
| Gene L Tran | Neurology | Facey Medical Foundation | 23803 Mcbean Pkwy, Suite 202, Valencia, CA 91355-2001 |
| Mark L Geller | Internal Medicine | Facey Medical Foundation | 18133 Ventura Blvd, Suite 204, Tarzana, CA 91356-3641 |
| Jennifer A Shields | Physical Therapy | Facey Medical Foundation | 27924 Seco Canyon Rd, Santa Clarita, CA 91350-3870 |
| Shohreh Sayani | Podiatry | Facey Medical Foundation | 19950 Rinaldi St, Suite 103, Porter Ranch, CA 91326-4141 |
| Fausto Santiago Cordero | Family Medicine | Facey Medical Foundation | 9111 Corbin Ave, Northridge, CA 91324-2402 |
| Michael Jamil Dalali | Ophthalmology | Facey Medical Foundation | 14550 Soledad Canyon, Santa Clarita, CA 91387-3210 |
| Street Address |
17909 SOLEDAD CANYON RD SUITE 100 |
| City | CANYON COUNTRY |
| State | CA |
| Zip | 91387-3210 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ressie Ramos | Nurse Practitioner | Facey Medical Foundation | 17909 Soledad Canyon Rd, Suite 100, Canyon Country, CA 91387-3210 |
| Unber Ali | Internal Medicine | Facey Medical Foundation | 17909 Soledad Canyon Rd, Suite 100, Canyon Country, CA 91387-3210 |
| Mojgan Orsini | Registered Dietitian Or Nutrition Professional | Facey Medical Foundation | 17909 Soledad Canyon Rd, Suite 100, Canyon Country, CA 91387-3210 |
| Maria R Zambrano | Internal Medicine | Facey Medical Foundation | 17909 Soledad Canyon Rd, Suite 100, Canyon Country, CA 91387-3210 |
| Bina Maharjan | Family Medicine | Facey Medical Foundation | 17909 Soledad Canyon Rd, Suite 100, Canyon Country, CA 91387-3210 |
| Ghalaleh Erfanzadeh | Internal Medicine | Facey Medical Foundation | 17909 Soledad Canyon Rd, Suite 100, Canyon Country, CA 91387-3210 |
| Elma Babayans | Nurse Practitioner | Facey Medical Foundation | 17909 Soledad Canyon Rd, Canyon Country, CA 91387-3210 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Jamil Dalali | Ophthalmology | Facey Medical Foundation | 14550 Soledad Canyon, Santa Clarita, CA 91387-3210 |
| Victor Manuel Lopez | Pediatric Medicine | Facey Medical Foundation | 14550 Soledad Canyon, Santa Clarita, CA 91387-3210 |
| Tracey M Easterling | Nurse Practitioner | Facey Medical Foundation | 14550 Soledad Canyon, Santa Clarita, CA 91387-3210 |
| Sandra Lee Lazaros | Speech Language Pathologist | 17761 Heron Ln, Santa Clarita, CA 91387-6386 |
| City | CANYON COUNTRY |
| Zip Code | 91387 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | CANYON COUNTRY + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Vernon H Lackman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.