NPIMap

Organization Active NPI

Yaroslav a. Gofnung, M.D., Inc.

  • Endocrinology, Diabetes & Metabolism Physician
  • North Hollywood, CA
National Provider Identifier
1013024876
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A81752 Issued in CA
Legal business name
YAROSLAV A. GOFNUNG, M.D., INC.
Practice address
12660 Riverside Dr
Suite 225
North Hollywood, CA 91607-3429
Phone
(818) 487-0040
Fax
(818) 487-0050
NPI assigned
Aug 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paula Martinez
Title
Billing/Credentialing
Phone
(818) 908-8048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X A81752 CA Primary

Addresses

Primary practice location

12660 Riverside Dr
Suite 225
North Hollywood, CA 91607-3429

Mailing address

12660 Riverside Dr
Suite 225
North Hollywood, CA 91607-3429
Phone (818) 487-0040

National Provider Directory

National Provider Directory

Locations

5805 Sepulveda Blvd
Ste 610
Van Nuys, CA 91411
Phone (818) 908-8048

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1013024876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR",
            "address_2": "SUITE 225",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073429",
            "telephone_number": "818-487-0040",
            "fax_number": "818-487-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR",
            "address_2": "SUITE 225",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073429",
            "telephone_number": "818-487-0040",
            "fax_number": "818-487-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAROSLAV A. GOFNUNG, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING",
        "authorized_official_telephone_number": "818-908-8048"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A81752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.