Gary Reznik M. D. Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G67314 Issued in CA

Legal business name

GARY REZNIK M. D. INC

Practice address

6333 Wilshire Blvd Ste 200
Los Angeles, CA 90048-5724

Phone

(323) 653-2504

Fax

(323) 653-2515

NPI assigned

Jan 22, 2008

Last updated

May 31, 2012By 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

Dr. Gary Reznik, M.D.NPI 1043244296

Title

President

Phone

(323) 653-2504

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Gary Reznik, MD

  • Cardiovascular Disease Physician
  • Los Angeles, CA
  • NPI 1043244296
  Medicare reassignment NPD Authorized official
• Ilya Gelman, M.D.

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1811008022
  NPD

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1215114251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 WILSHIRE BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485724",
            "telephone_number": "323-653-2504",
            "fax_number": "323-653-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 WILSHIRE BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485724",
            "telephone_number": "323-653-2504",
            "fax_number": "323-653-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY REZNIK M. D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "REZNIK",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-653-2504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G67314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "W21850",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "WG67314F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215114251",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.