Provider Demographics
NPI:1750348785
Name:GETZUG, SHELDON JOEL (MD)
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:JOEL
Last Name:GETZUG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18425 BURBANK BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2806
Mailing Address - Country:US
Mailing Address - Phone:818-708-6000
Mailing Address - Fax:818-708-6009
Practice Address - Street 1:18425 BURBANK BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6691
Practice Address - Country:US
Practice Address - Phone:818-708-6000
Practice Address - Fax:818-708-6009
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA19118207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ70039ZMedicaid
CAZZZ70039ZMedicaid
CAW1132Medicare ID - Type Unspecified