Izhr Gocong, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

202474 Issued in CA

Practice address

4838 Laurel Canyon Blvd
North Hollywood, CA 91607-3717

Phone

(818) 506-4455

NPI assigned

Feb 3, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Pacific Med-Corp

  • Methadone Clinic
  • Mission Viejo, CA
  • NPI 1386280899
  NPD (past)

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625961600000",
    "number": "1508457375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4838 LAUREL CANYON BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073717",
            "telephone_number": "818-506-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4838 LAUREL CANYON BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073717",
            "telephone_number": "818-506-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOCONG",
        "first_name": "IZHR",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "202474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERANS AFFAIRS",
            "identifier": "7346243588",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Global Hospice & Palliative Services, Inc.
• GMH Home Health Inc
• Gmi Laboratories LLC
• Gmomentum Inc
• Gna Home Health Care
• Irina Godes, MD
• Gods Army Wellness Home Inc
• Godwill Hospice,Inc.
• Yaroslav A Gofnung, MD
• Akhtar Golbahar

• Licensed Vocational Nurse in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2021; 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.