GENNADIY VENGEROVICH (NPI# 1477708907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477708907 |
| Entity Type | Individual |
| Full Name | GENNADIY VENGEROVICH |
| Practice Address |
200 Ucla Medical Plz Ste 550 Los Angeles CA 90095 |
| Mailing Address |
5767 W Century Blvd Ste 400 Los Angeles CA 90045-5631 |
| Practice Telephone | 3102036688 |
| Mailing Telephone | 6462438934 |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2018-07-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | C154498 | CA | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 261799 | NY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Ucla Medical Plz Fl 6, Los Angeles, CA 900957104 | 3102066688 |
| Street Address |
200 UCLA MEDICAL PLZ STE 550 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073733861 | Alisha West | Otolaryngology | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095 | 2007-04-26 |
| 1891322582 | Emily Claire Wong | Student in an Organized Health Care Education/Training Program | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095-8344 | 2020-03-24 |
| 1780154534 | Ashley Lynn Modi | Nurse Practitioner | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095-8344 | 2018-12-04 |
| 1154717692 | Daniel Chendana Sukato | Otolaryngology | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095-2012 | 2015-04-10 |
| 1295120681 | Timothy Carter Blood Jr. | Otolaryngology | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095-0001 | 2015-04-01 |
| 1508250622 | Justin Mccormick | Otolaryngology | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095-2238 | 2015-03-26 |
| 1548673692 | Taylor Rose Carle | Otolaryngology | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095 | 2014-06-06 |
| 1881013852 | Rhorie Kerr | Otolaryngology | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095 | 2014-04-07 |
| 1023436490 | Alisa Zhukhovitskaya | Otolaryngology | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095 | 2014-04-02 |
| 1831455328 | Daniel Morris Beswick | Otolaryngology | 200 Ucla Medical Plz Ste 550, Los Angeles, CA 90095-2545 | 2012-04-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212155 | Alexandra Gubin | Social Worker | Ucla, 757 Westwood Medical Plaza, Los Angeles, CA 90095 | 2020-07-14 |
| 1952926263 | Georgina Parra | Student in an Organized Health Care Education/Training Program | 10833 Le Conteave, Los Angeles, CA 90095 | 2020-06-11 |
| 1609403575 | Yagmur Muftuoglu | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Neurosurgery, Los Angeles, CA 90095 | 2020-03-23 |
| 1619438173 | Brandon Covington Smith | Student in an Organized Health Care Education/Training Program | 727 Westwood Plaza, Dept of Internal Medicine, Los Angeles, CA 90095 | 2019-03-27 |
| 1184184913 | Alexander Daniel Yuen | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza (internal Medicine), Los Angeles, CA 90095 | 2019-03-19 |
| 1790266369 | Dana Saifan | Student in an Organized Health Care Education/Training Program | 1000 Veteran Avenue, Los Angeles, CA 90095 | 2018-08-22 |
| 1427549146 | Courtney Renee' Real | Registered Nurse | 757 Westwood Plz Ste 6236, Los Angeles, CA 90095 | 2018-05-29 |
| 1932605094 | Akash Atul Shah | Student in an Organized Health Care Education/Training Program | Ucla Department of Orthopaedic Surgery, 10833 Le Conte Avenue, 76-116 Chs, Los Angeles, CA 90095 | 2018-04-05 |
| 1316443435 | Dane Jensen Brodke | Orthopaedic Surgery | 757 Westwood Plaza, (orthopaedic Surgery), Los Angeles, CA 90095 | 2018-04-05 |
| 1477058824 | Thomas William Gaither Castellanos | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Urology, Los Angeles, CA 90095 | 2018-03-28 |
| Find all providers in zip 90095 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598280901 | Kian Karimi Md Inc | Otolaryngology | 11645 Wilshire Blvd Fl 6, Los Angeles, CA 90025-6807 | 2017-08-07 |
| 1770906687 | David Carl Marcusen | Otolaryngology | 660 N Gramercy Pl, Los Angeles, CA 90004-1702 | 2014-01-28 |
| 1124451505 | Karam Badran | Otolaryngology | 10833 Le Conte Ave Chs 62-132, Department of Head and Neck Surgery, Los Angeles, CA 90095-1624 | 2013-08-20 |
| 1528490554 | Los Angeles Ent Surgical Associates | Otolaryngology | 1700 E. Cesar Chavez Ave, Suite 2500, Los Angeles, CA 90033 | 2013-08-01 |
| 1598011397 | Mehdi Sina | Otolaryngology | 1401 S Bentley Ave Apt 203, Los Angeles, CA 90025-8031 | 2012-07-30 |
| 1134486681 | Kevin Jae Choi | Otolaryngology | 966 S Western Ave Ste 101, Los Angeles, CA 90006-1014 | 2012-04-20 |
| 1649577156 | Hanwon H Cho | Otolaryngology | 11706 Montana Ave Apt 210, Los Angeles, CA 90049-6724 | 2011-02-17 |
| 1588822100 | Gary S Bellack Md Inc | Otolaryngology | 8631 W Third St, Suite 225, Los Angeles, CA 90048-5901 | 2008-05-30 |
| 1730359258 | Kimanh Duong Nguyen | Otolaryngology | 600 South San Vicente Blvd, Los Angeles, CA 90048 | 2008-03-11 |
| 1669657748 | Jennifer Lynn Long | Otolaryngology | 200 Medical Plaza Suite 550, Los Angeles, CA 90095-6975 | 2008-01-08 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90095 |
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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.