Alan Darush, M.D., a Professional Corporation
Organization Active NPI Internal Medicine Physician · Northridge, CA
NPI 1669501409 · NPPES record last updated Dec 11, 2014
Key facts
- NPI
- 1669501409
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A84425 (CA)
- Legal business name
- ALAN DARUSH, M.D., A PROFESSIONAL CORPORATION
- Practice address
- 8540 Reseda Blvd # 103
Northridge, CA 91324-4628 - Phone
- (818) 280-0700
- NPI assigned
- Mar 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Alan Darush, M.D.
- Title
- Owner
- Phone
- (818) 280-0700
Practitioners 2
-
Alan Darush, M.D.
-
Monica Mikhael, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081114000442 | CA | Part B Supplier - Clinic/Group Practice | 0244390649 |
Receives reassigned benefits from 1 practitioner Practice locations: Northridge, CA; Simi Valley, CA |
National Provider Directory
Locations
1189 Swallow Ln
Ste 100
Simi Valley, CA 93065
Phone (805) 526-3365
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | A84425 | CA | Yes |
Addresses
Primary practice location
8540 Reseda Blvd # 103
Northridge, CA 91324-4628
Mailing address
PO Box 77790
Corona, CA 92877-0126
Phone (800) 624-2468
Other providers in Northridge, CA
- Joe Akrabowon
- Akt Care Home Inc
- Usriya Shariff Al-Shiraz
- Yelena Aladadyan
- Alain Karaguezian MD PC
- Betssy R Alanya
- Kimberly Alanya
- Luz E Alas
- Vanessa C Alba
- Albemar Espiritu DPM, Inc
All providers in Northridge, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.