Provider Demographics
NPI:1265642185
Name:STEVEN A. DRELL M D & H. LEE KAGAN M D, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:STEVEN A. DRELL M D & H. LEE KAGAN M D, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-784-9905
Mailing Address - Street 1:13320 RIVERSIDE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2502
Mailing Address - Country:US
Mailing Address - Phone:818-784-9905
Mailing Address - Fax:
Practice Address - Street 1:13320 RIVERSIDE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2502
Practice Address - Country:US
Practice Address - Phone:818-784-9905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16434Medicare ID - Type UnspecifiedGROUP NUMBER