Provider Demographics
NPI:1710076054
Name:FRANKL, SALLY B (MD)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:B
Last Name:FRANKL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:BELCOVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18375 VENTURA BLVD
Mailing Address - Street 2:SUITE 626
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4218
Mailing Address - Country:US
Mailing Address - Phone:818-908-8048
Mailing Address - Fax:818-908-8072
Practice Address - Street 1:5525 ETIWANDA AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3647
Practice Address - Country:US
Practice Address - Phone:818-344-2080
Practice Address - Fax:818-758-3646
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1710076054OtherNPI
CA1992894240OtherGROUP NPI
CA1992894240OtherGROUP NPI
CAWG64000CMedicare PIN