Victor M. Wassily, M.D. Inc.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A53474 Issued in CA

Legal business name

VICTOR M. WASSILY, M.D. INC.

Practice address

111 W Beverly Blvd Ste 217
Montebello, CA 90640-4320

Phone

(323) 722-7711

Fax

(323) 722-7127

NPI assigned

Aug 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Victor M Wassily, M.D.NPI 1962423590

Title

President

Phone

(323) 722-7711

Specialties & licenses 1

Addresses

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, and the practitioner matching its NPPES authorized official.

• Victor M Wassily, M.D.

  • Nephrology Physician
  • Montebello, CA
  • NPI 1962423590
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250812800000",
    "number": "1215169396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W BEVERLY BLVD STE 217",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404320",
            "telephone_number": "323-722-7711",
            "fax_number": "323-722-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W BEVERLY BLVD STE 217",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404320",
            "telephone_number": "323-722-7711",
            "fax_number": "323-722-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR M. WASSILY, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-21",
        "last_updated": "2009-08-21",
        "status": "A",
        "authorized_official_last_name": "WASSILY",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-722-7711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A53474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Montebello, CA
• Providers in Montebello, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; 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.