Vanowen Radiology Medical Group

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

VANOWEN RADIOLOGY MEDICAL GROUP

Practice address

15243 Vanowen St Ste 106
Van Nuys, CA 91405-3632

Phone

(818) 782-6110

NPI assigned

May 20, 2006

Last updated

Jun 16, 2009By 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

Larry Kussin, M.D.NPI 1235189994

Title

Medical Director

Phone

(818) 782-6110

Specialties & licenses 1

Addresses

Other identifiers 4

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.

• Larry Kussin, M.D.

  • Diagnostic Radiology Physician
  • Van Nuys, CA
  • NPI 1235189994
  NPD (past) Authorized official

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1306890504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930620190",
            "telephone_number": "805-522-5940",
            "fax_number": "805-522-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST STE 106",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053632",
            "telephone_number": "818-782-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANOWEN RADIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "KUSSIN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-782-6110",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0082840",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CS9153",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ73154Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ73154Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harry Lee Vannatta, BS, MPH
• Vanowen Adhc
• Vanowen Dental Center
• Vanowen Optimal Health Care Inc
• Vanowen Radiological Medical Group, Inc.
• Vapiano Hospice Care, Inc.
• Ixia Vaquis
• Paola Varas
• Emma Vardanian
• Vahe Vardanian

• Diagnostic Radiology Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.