NEIL D. FAGEN,M.D.,INC. (NPI# 1023311008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023311008 |
| Entity Type | Organization |
| Organization Name | NEIL D. FAGEN,M.D.,INC. |
| Practice Address |
18411 Clark St 204 Tarzana CA 91356-3535 |
| Practice Telephone | 8189964796 |
| Practice Fax Number | 8189964793 |
| Mailing Telephone | 8189964796 |
| Mailing Fax Number | 8189964793 |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2010-12-13 |
| Authorized Official Name | DR. NEIL D FAGEN (PRESIDENT) |
| Authorized Official Telephone | 8189964796 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G293040 | 05 |
| Street Address |
18411 CLARK ST 204 |
| City | TARZANA |
| State | CA |
| Zip Code | 91356-3535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922082452 | Karyn Leigh Gross | Obstetrics & Gynecology | 18411 Clark St, # 304, Tarzana, CA 91356-3506 | 2005-11-29 |
| 1083005672 | Sonia Delacruz | Specialist | 18411 Clark St, Suite 302, Tarzana, CA 91356-3506 | 2015-02-18 |
| 1033512439 | Michelle Rebecca Fouladian | Physician Assistant | 18411 Clark St, Suite 302, Tarzana, CA 91356-3506 | 2014-09-30 |
| 1598189755 | Theresa Daggi | Nurse Practitioner | 18411 Clark St, Suite 301, Tarzana, CA 91356-3506 | 2014-02-08 |
| 1700037710 | George A Maranon Oral Maxillofacial Surgery | Dentist | 18411 Clark St, Suite # 204, Tarzana, CA 91356-3506 | 2008-10-08 |
| 1215107792 | Brian K Fenmore Md | Obstetrics & Gynecology | 18411 Clark St, 108, Tarzana, CA 91356-3506 | 2008-03-11 |
| 1578741823 | Jehuda Renan | Obstetrics & Gynecology | 18411 Clark St, Suite 103, Tarzana, CA 91356-3506 | 2008-02-07 |
| 1790997856 | Samuel Spigelman Md A Professional Corporation | Urology | 18411 Clark St, Suite 104, Tarzana, CA 91356 | 2007-05-03 |
| 1659407120 | Valley Foot Surgeons, A Podiatry Group, Inc. | Podiatrist | 18411 Clark St, Suite 107, Tarzana, CA 91356-3506 | 2007-02-26 |
| 1881734234 | Peter R. Rubenstein M D A Medical Corporation | Obstetrics & Gynecology | 18411 Clark St, Suite 307, Tarzana, CA 91356-3506 | 2007-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679137293 | Sarah Badreau | Behavior Technician | 5554 Reseda Blv., Tarzana, CA 91356 | 2019-04-29 |
| 1831661966 | Daraie Dental Group Inc | Dentist | 5620 Wilbur Avenue Ste 300, Tarzana, CA 91356 | 2018-12-31 |
| 1982182770 | Blanca Garay | Respiratory Therapist, Registered | 18214 Burbank Blvd Apt 120, Tarzana, CA 91356 | 2018-08-02 |
| 1437659000 | Chloe Kang | Speech-Language Pathologist | 19019 Ventura Blvd., Tarzana, CA 91356 | 2018-02-20 |
| 1114430139 | Avb & Lv Corporation | Home Health | 18340 Ventura Blvd Ste 220, Tarzana, CA 91356 | 2017-11-13 |
| 1881110468 | Samina Qadir | Registered Nurse | 18321 Clark St., Tarzana, CA 91356 | 2017-08-16 |
| 1700306776 | Debbie Rehman Lux | Marriage & Family Therapist | 18370 Burbank Blvd., Suite 211, Tarzana, CA 91356 | 2017-06-21 |
| 1467980631 | Valley Nerological Services, LLC | Radiology | 5260 Wilbur Ave Ste 207, Tarzana, CA 91356 | 2017-05-31 |
| 1669906020 | Evolve Growth Initiatives LLC | Clinic/Center | 5435 Aura Avenue, Tarzana, CA 91356 | 2017-04-12 |
| 1780130088 | Evolve Growth Initiatives, LLC | Clinic/Center | 5358 Vanalden Drive, Tarzana, CA 91356 | 2016-08-28 |
| Find all providers in zip 91356 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295810323 | San Fernando Valley Gastroenterology Medical Group Inc | Internal Medicine | 18425 Burbank Blvd Ste 500, Tarzana, CA 91356-6691 | 2006-10-26 |
| 1184600074 | Maurice Gourdji Md Inc & Lucien R Jacobs Md Inc | Internal Medicine | 18425 Burbank Blvd, Suite 500, Tarzana, CA 91356-2806 | 2005-12-21 |
| 1700878428 | Neil D Fagen | Internal Medicine | 18411 Clark St Ste 204, Tarzana, CA 91356-3535 | 2005-08-18 |
| 1982696613 | Michael Madievsky | Internal Medicine | 5525 Etiwanda Ave Ste 110, Tarzana, CA 91356-3642 | 2005-08-18 |
| 1437463957 | Marcos B Fleiderman M D Medical Corporation | Internal Medicine | 18372 Clark St, Suite 212, Tarzana, CA 91356-3508 | 2010-07-27 |
| 1508006339 | Maurice Gourdji Md Inc | Internal Medicine | 18425 Burbank Blvd, Suite 500, Tarzana, CA 91356-2806 | 2009-03-06 |
| 1902047749 | Lucien R Jacobs Md Inc | Internal Medicine | 18425 Burbank Blvd, Suite 500, Tarzana, CA 91356-2806 | 2009-03-06 |
| 1558540294 | Michael Madievsky,m.d. | Internal Medicine | 18411 Clark St Ste 204, Tarzana, CA 91356-3535 | 2007-10-30 |
| 1144305244 | Lori Yep Kam | Internal Medicine | 18425 Burbank Blvd, Tarzana, CA 91356-2806 | 2006-10-26 |
| 1366400194 | Jim Amerian | Internal Medicine | 18425 Burbank Blvd, Suite 500, Tarzana, CA 91356-2806 | 2006-05-02 |
| Find all providers in TARZANA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.