Provider Demographics
NPI:1164433868
Name:BEN-ZUR, URI M (MD,FACC)
Entity Type:Individual
Prefix:DR
First Name:URI
Middle Name:M
Last Name:BEN-ZUR
Suffix:
Gender:M
Credentials:MD,FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17412 VENTURA BLVD
Mailing Address - Street 2:# 138
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3827
Mailing Address - Country:US
Mailing Address - Phone:818-788-8568
Mailing Address - Fax:
Practice Address - Street 1:18200 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4229
Practice Address - Country:US
Practice Address - Phone:818-986-0911
Practice Address - Fax:818-986-9301
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75051207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G750510Medicare ID - Type Unspecified
F32892Medicare UPIN