Provider Demographics
NPI:1346394459
Name:GUZIEL & SCHOENFELD NEPHROLOGY & INTERNAL MEDICINE AFFILIATES
Entity Type:Organization
Organization Name:GUZIEL & SCHOENFELD NEPHROLOGY & INTERNAL MEDICINE AFFILIATES
Other - Org Name:G & S DIALYSIS ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:P
Authorized Official - Last Name:GUZIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-668-8869
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:#504
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2804
Mailing Address - Country:US
Mailing Address - Phone:818-345-0664
Mailing Address - Fax:818-345-1866
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:#504
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-345-0664
Practice Address - Fax:818-345-1866
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUZIEL & SCHOENFELD NEPHROLOGY & INTERNAL MEDICINE AFFILIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-23
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10627174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0009390Medicaid
CAW6677Medicare PIN
W6677Medicare ID - Type Unspecified
CAF01871Medicare UPIN
CAGR0009390Medicaid