Organization Active NPI

Medical Group of Encino, Inc

  • Internal Medicine Physician
  • Encino, CA
National Provider Identifier
1801805874
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL GROUP OF ENCINO, INC
Practice address
16030 Ventura Boulevard
Suite 680
Encino, CA 91436-2726
Phone
(818) 990-1067
Fax
(818) 981-1217
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Authorized official

Name
Dr. Richard Lawrence Wulfsberg, MD
Title
Vice President Treasurer
Phone
(818) 990-1067

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

16030 Ventura Boulevard
Suite 680
Encino, CA 91436-2726

Mailing address

16030 Ventura Boulevard
Suite 680
Encino, CA 91436-2726
Phone (818) 990-1067

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1801805874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16030 VENTURA BOULEVARD",
            "address_2": "SUITE 680",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362726",
            "telephone_number": "818-990-1067",
            "fax_number": "818-981-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16030 VENTURA BOULEVARD",
            "address_2": "SUITE 680",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362726",
            "telephone_number": "818-990-1067",
            "fax_number": "818-981-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL GROUP OF ENCINO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "WULFSBERG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "VICE PRESIDENT TREASURER",
        "authorized_official_telephone_number": "818-990-1067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.