Provider Demographics
NPI:1518257450
Name:VICTOR V. STRELZOW, M.D., INC.
Entity Type:Organization
Organization Name:VICTOR V. STRELZOW, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:VITALY
Authorized Official - Last Name:STRELZOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD, INC
Authorized Official - Phone:949-753-9299
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 704
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-753-9299
Mailing Address - Fax:949-753-7417
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 704
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-753-9299
Practice Address - Fax:949-753-7417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32942174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26983Medicare UPIN