PACIFIC DIABETES INSTITUTE, INC. (NPI# 1710231626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710231626 |
| Entity Type | Organization |
| Organization Name | PACIFIC DIABETES INSTITUTE, INC. |
| Practice Address |
15107 Vanowen St Amputation Prevention Center - 4 East Van Nuys CA 91405-4542 |
| Mailing Address |
Po Box 914 Beverly Hills CA 90213-0914 |
| Practice Telephone | 8189025755 |
| Practice Fax Number | 8189043708 |
| Mailing Telephone | 3108698857 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |
| Authorized Official Name | DR. DAVID POUGATSCH (PRESIDENT/CEO) |
| Authorized Official Telephone | 3108698857 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| Street Address |
15107 VANOWEN ST AMPUTATION PREVENTION CENTER - 4 EAST |
| City | VAN NUYS |
| State | CA |
| Zip Code | 91405-4542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508854225 | Apostolos Anthony Lekkos | Emergency Medicine | 15107 Vanowen St, Van Nuys, CA 91405 | 2005-10-06 |
| 1023622586 | Marina A Salama Md Inc | Pediatrics | 15107 Vanowen St, Van Nuys, CA 91405-4597 | 2020-09-02 |
| 1831708452 | Emma Brand Constantinou | Physician Assistant | 15107 Vanowen St, Van Nuys, CA 91405-4597 | 2020-07-29 |
| 1467075531 | Rachel Hroncich | Pharmacist | 15107 Vanowen St, Van Nuys, CA 91405 | 2020-05-24 |
| 1376165563 | Julie Tang | Dietitian, Registered | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2020-05-11 |
| 1265062913 | Suzanne Patricia Graf | Clinical Nurse Specialist | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2020-01-22 |
| 1760028831 | Mary Catherine Soliva | Physical Therapist | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2019-11-22 |
| 1538705215 | Team Hospital Medicine Physicians of California Medical Group Inc | Hospitalist | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2019-11-18 |
| 1952867020 | Faula Anne Pena Bordon | Occupational Therapist | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2019-02-14 |
| 1598220881 | John Joseph Broz IIi | Physician Assistant | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2019-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033955 | Pro-med Hospice Inc | Hospice Care, Community Based | 6621 Van Nuys Blvd, Unit 108, Van Nuys, CA 91405 | 2020-11-08 |
| 1205452174 | Graeme Matthewson | Student in an Organized Health Care Education/Training Program | 6815 Noble Avenue, Van Nuys, CA 91405 | 2020-06-17 |
| 1023671179 | Cory Andrew Kwong | Student in an Organized Health Care Education/Training Program | C/o Lauren Daoust - Southern California Orthopedic Inst, 6815 Noble Avenue, Van Nuys, CA 91405 | 2019-04-15 |
| 1871052878 | Eric Nunez | Behavior Technician | 7226 Sepulveda Boulevard, Van Nuys, CA 91405 | 2019-03-19 |
| 1487113437 | Cindy Antillon | Behavior Technician | 7226 Sepulveda Blvd. Van Nuys, Ca 91405, Van Nuys, CA 91405 | 2019-03-19 |
| 1326507690 | Jordan Elliot Brooks | Behavior Technician | 7226 Sepulveda Blvd., Van Nuys, CA 91405 | 2019-03-17 |
| 1689132110 | Bright Star Home Health Care, Inc. | Home Health | 7141 Wooley Ave, Van Nuys, CA 91405 | 2019-03-04 |
| 1336650498 | Avanti Transportation Services, LLC | Private Vehicle | 7020 Lennox Ave #7, Van Nuys, CA 91405 | 2017-10-17 |
| 1801312434 | Marissa Topete | Rehabilitation Counselor | 14624 Sherman Way, Suite 404, Van Nuys, CA 91405 | 2017-08-15 |
| 1750802468 | Selin Ani Zarmanoglu | Marriage & Family Therapist | 14600 Sherman Way #100d, Van Nuys, CA 91405 | 2017-07-03 |
| Find all providers in zip 91405 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689066581 | Valley Foot Clinic Professional Corporation | Podiatrist | 14600 Sherman Way Ste 230, Van Nuys, CA 91405-2291 | 2015-03-02 |
| 1710306501 | New Age Foot and Ankle Podiatry PC | Podiatrist | 16935 Vanowen St, Suite E, Van Nuys, CA 91406-4595 | 2014-04-09 |
| 1912335381 | Christopher Otiko | Podiatrist | 16122 Covello St, Van Nuys, CA 91406-2910 | 2013-10-23 |
| 1790112654 | Valley Oaks Podiatry Group | Podiatrist | 16122 Covello St, Van Nuys, CA 91406-2910 | 2013-10-08 |
| 1033410675 | Ronald J Belczyk, Dpm Inc. | Podiatrist | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2010-11-13 |
| 1265762090 | Nicholas J Bevilacqua D P M Inc | Podiatrist | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2009-12-29 |
| 1235466798 | Lee C. Rogers, D.p.m., Inc. | Podiatrist | 15107 Vanowen St, Van Nuys, CA 91405-4542 | 2009-11-04 |
| 1295967719 | Tae Hyun Kim Dpm Inc | Podiatrist | 13701 Burbank Blvd, Van Nuys, CA 91401-5040 | 2009-08-17 |
| 1316126618 | Loris Yadegarian Dpm | Podiatrist | 14600 Sherman Way, Suite 210, Van Nuys, CA 91405-2269 | 2007-11-02 |
| 1720163710 | Aziz Berjis | Podiatrist | 6850 Sepulveda Blvd, #209, Van Nuys, CA 91405-4444 | 2006-10-26 |
| Find all providers in VAN NUYS | ||||
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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.