Provider Demographics
NPI:1013068931
Name:BERDISCHEWSKY, MYRON TZALEL (MD)
Entity type:Individual
Prefix:DR
First Name:MYRON
Middle Name:TZALEL
Last Name:BERDISCHEWSKY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14301 MILLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-4426
Mailing Address - Country:US
Mailing Address - Phone:818-907-6103
Mailing Address - Fax:
Practice Address - Street 1:12215 VENTURA BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2533
Practice Address - Country:US
Practice Address - Phone:818-769-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG34045207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG34045OtherMEDICAL BOARD OF CA
AB7527407OtherDEA REGISTRATION
CAA91558Medicare UPIN