Tarzana Pediatric Medical Group Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G16804 Issued in CA

Legal business name

TARZANA PEDIATRIC MEDICAL GROUP INC

Practice address

18370 Burbank Blvd
Suite #204
Tarzana, CA 91356-2851

Phone

(818) 345-7792

Fax

(818) 345-9052

NPI assigned

Aug 29, 2006

Last updated

Aug 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Norman Lavin, MDNPI 1811902786

Title

Owner

Phone

(818) 345-7792

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Norman Lavin, MD

  • Pediatrics Physician
  • Tarzana, CA
  • NPI 1811902786

  Endocrinology, Diabetes & Metabolism

  Medicare reassignment NPD Authorized official
• Robert Warren Jackson

  • Nurse Practitioner
  • Tarzana, CA
  • NPI 1689471310
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407801600000",
    "number": "1033227970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18370 BURBANK BLVD",
            "address_2": "SUITE #204",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562851",
            "telephone_number": "818-345-7792",
            "fax_number": "818-345-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18370 BURBANK BLVD",
            "address_2": "SUITE #204",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562851",
            "telephone_number": "818-345-7792",
            "fax_number": "818-345-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARZANA PEDIATRIC MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-08-12",
        "status": "A",
        "authorized_official_last_name": "LAVIN",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-345-7792",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "G16804",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G16804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G16804",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0002970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tarzana Manor
• Tarzana Medical Center LLC (Providence Cedars-Sinai Tarzana Medical Center)
• Tarzana Medical Urgent Care - a Professional Medical Corporation
• Tarzana Optimal Medical Center Inc
• Tarzana Pain and Wound Center
• Tarzana Post Acute LLC (Tarzana Health and Rehabilitation Center)
• Tarzana Recovery Center, Inc,
• Tarzana Senior Living, Inc.
• Tarzana Surgery Center, Inc.
• Tarzana Surgery Center, Inc.

• Pediatrics Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.