Philip Conwisar MD Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G74333 Issued in CA

Legal business name

PHILIP CONWISAR MD INC.

Doing business as

Valley Care Center

Practice address

4835 Van Nuys Blvd
Suite 210
Sherman Oaks, CA 91403-2109

Phone

(818) 784-1354

Fax

(818) 784-5705

NPI assigned

Sep 26, 2011

Organization subpart

No

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

Authorized official

Name

Philip Conwisar, M.D.NPI 1699883926

Title

Owner

Phone

(818) 784-1354

Specialties & licenses 1

Addresses

Other names 1

• Valley Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Philip H Conwisar, MD

  • Orthopaedic Surgery Physician
  • Sherman Oaks, CA
  • NPI 1699883926
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1184907123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 VAN NUYS BLVD",
            "address_2": "SUITE 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032109",
            "telephone_number": "818-784-1354",
            "fax_number": "818-784-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 VAN NUYS BLVD",
            "address_2": "SUITE 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032109",
            "telephone_number": "818-784-1354",
            "fax_number": "818-784-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP CONWISAR MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "CONWISAR",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-784-1354",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G74333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthopaedic Surgery Physician in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.