Provider Demographics
NPI:1336339738
Name:GENDELMAN, VLAD (MD, FAAOS)
Entity Type:Individual
Prefix:DR
First Name:VLAD
Middle Name:
Last Name:GENDELMAN
Suffix:
Gender:M
Credentials:MD, FAAOS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10640 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2319
Mailing Address - Country:US
Mailing Address - Phone:818-344-6784
Mailing Address - Fax:818-344-6785
Practice Address - Street 1:10640 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-2319
Practice Address - Country:US
Practice Address - Phone:818-344-6784
Practice Address - Fax:818-344-6785
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101034207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery