Provider Demographics
NPI:1164464780
Name:SZATALOWICZ, VICTORIA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LYNN
Last Name:SZATALOWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 622
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-0622
Mailing Address - Country:US
Mailing Address - Phone:310-419-8693
Mailing Address - Fax:310-836-0592
Practice Address - Street 1:555 E HARDY ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4011
Practice Address - Country:US
Practice Address - Phone:310-419-8636
Practice Address - Fax:310-963-0403
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39183207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C391830Medicaid
CA00C391830Medicaid
CAWC39183Medicare ID - Type Unspecified