Provider Demographics
NPI:1043871627
Name:GY MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:GY MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUZEF
Authorized Official - Middle Name:
Authorized Official - Last Name:GUROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:818-483-4717
Mailing Address - Street 1:7400 VAN NUYS BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-1972
Mailing Address - Country:US
Mailing Address - Phone:818-483-4717
Mailing Address - Fax:
Practice Address - Street 1:7400 VAN NUYS BLVD STE 112
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-1972
Practice Address - Country:US
Practice Address - Phone:818-483-4717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty