Individual provider Active NPI

Ruslana Kadze, M.D.

  • Obstetrics & Gynecology Physician
  • Tarzana, CA
National Provider Identifier
1598825523
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A73273 Issued in CA
Practice address
18411 Clark St Ste 300
Tarzana, CA 91356-3546
Phone
(818) 343-1717
Fax
(818) 343-1718
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A73273 CA Primary

Addresses

Primary practice location

18411 Clark St Ste 300
Tarzana, CA 91356-3546

Mailing address

PO Box 3098
Torrance, CA 90510-3098
Phone (310) 792-3914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040511000429 CA Practitioner - Obstetrics/Gynecology 7911995014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A73273CAMDObstetrics & Gynecology Physician

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
So-Cal Community Health CenterArleta, CA, CCN A01926 Federally qualified health center Corporate Director Sep 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1598825523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3098",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103098",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST STE 300",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563546",
            "telephone_number": "818-343-1717",
            "fax_number": "818-343-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADZE",
        "first_name": "RUSLANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A73273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.