NEW LIFE MALE MEDICAL CENTER INC. (NPI# 1851800379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851800379 |
| Entity Type | Organization |
| Organization Name | NEW LIFE MALE MEDICAL CENTER INC. |
| Practice Address |
1577 E Chevy Chase Dr Ste 240 Glendale CA 91206-4742 |
| Practice Telephone | (818) 937-9551 |
| Practice Fax Number | 8184842116 |
| Mailing Telephone | 8189379551 |
| Mailing Fax Number | 8184842116 |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-09-27 |
| Authorized Official Name | DR. HOWARD LAZERSON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8189379551 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 51964 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1577 E CHEVY CHASE DR STE 240 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91206-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558737791 | Martin Airian | Physician Assistant | 1577 E Chevy Chase Dr Ste 240, Glendale, CA 91206-4742 | 2015-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922611003 | Skyla L Bergin | Behavior Technician | 741 Glenvia St., Suite 200, Glendale, CA 91206 | 2020-08-28 |
| 1861017303 | Scm Nutrition Diet Inc | Dietitian, Registered | 2437 Bywood Drive, Glendale, CA 91206 | 2020-06-10 |
| 1336761295 | Glendale Whole Health | Family Medicine | 230 N Maryland Aave #110, Glendale, CA 91206 | 2020-05-14 |
| 1467010801 | Rebecca Bautista | Counselor | 223 North Jackson Street, Glendale, CA 91206 | 2019-05-31 |
| 1689132920 | M4l Transport Inc | Non-emergency Medical Transport (VAN) | 336 N Louise St #4d, Glendale, CA 91206 | 2019-03-05 |
| 1376042705 | Eileen Wong, Md Inc. | Physical Medicine & Rehabilitation | 2664 E Glenoaks Blvd, Glendale, CA 91206 | 2018-02-12 |
| 1629507900 | Aleksan Chakhoyan | Registered Nurse | 501 N. Glendale Ave., Glendale, CA 91206 | 2017-06-08 |
| 1851793343 | Sevak Olmessekian | Pharmacist | 230 N. Maryland Ave., Suite 307, Glendale, CA 91206 | 2014-09-16 |
| 1558762575 | Zyanya Mendoza | Clinical Neuropsychologist | 1560 E Chevy Chase Dr Ste 140, Glendale, CA 91206 | 2014-09-09 |
| 1629488358 | Nina Behdin | Surgery | 1560 E Chevy Chase Dr Ste 430, Glendale, CA 91206 | 2014-05-02 |
| Find all providers in zip 91206 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891268389 | John Joseph Granato Jr. | Urology | 333 Cumberland Rd, Glendale, CA 91202-1256 | 2019-01-07 |
| 1811207483 | Shahin Derboghossians Md Inc | Urology | 1030 S Glendale, 301, Glendale, CA 91205 | 2010-10-18 |
| 1285955823 | Kirsten Janna Chimwemwe Janosek-albright | Urology | 17560 N 75th Ave, Suite 440, Glendale, AZ 85308-5983 | 2010-06-17 |
| 1326371717 | Kamal Nagpal | Urology | 6320 W Union Hills Dr Ste 2600b, Glendale, AZ 85308-1379 | 2009-09-16 |
| 1922284579 | Yasmin I Bootwala | Urology | 6525 W Sack Dr Ste 201, Glendale, AZ 85308 | 2008-01-14 |
| 1073609178 | Ignacio Hoelzl Luna | Urology | 426 Eight Street, Suite 300, Glendale, WV 26038 | 2006-10-05 |
| 1538181474 | Ken-ryu Han | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2006-07-23 |
| 1710915038 | Shahin Derboghossians | Urology | 116 S Louise St, Glendale, CA 91205 | 2006-06-28 |
| 1023045713 | Carlton Francis Valvo | Urology | 1808 Verdugo Blvd Ste 110, Glendale, CA 91208-1450 | 2006-06-27 |
| 1508814138 | Glen-white Urological Medical Group Inc | Urology | 1560 East Chevy Chase Dr, Suite 325, Glendale, CA 91206 | 2006-05-05 |
| Find all providers in GLENDALE | ||||
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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.