Individual provider Active NPI

Gabriel Goren, MD

  • Vascular Surgery Physician
  • Encino, CA
National Provider Identifier
1821363201
Registry record updated Mar 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
AFE38681 Issued in CA
Practice address
16110 Ventura Blvd
Suite 303
Encino, CA 91436-2547
Phone
(818) 648-5931
NPI assigned
Mar 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X AFE38681 CA Primary

Addresses

Primary practice location

16110 Ventura Blvd
Suite 303
Encino, CA 91436-2547

Mailing address

16110 Ventura Blvd
Suite 303
Encino, CA 91436-2547
Phone (818) 648-5931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AFE38681CAMDVascular Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1332028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332028800000",
    "number": "1821363201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16110 VENTURA BLVD",
            "address_2": "SUITE 303",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362547",
            "telephone_number": "818-648-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 VENTURA BLVD",
            "address_2": "SUITE 303",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362547",
            "telephone_number": "818-648-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOREN",
        "first_name": "GABRIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-18",
        "last_updated": "2012-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "AFE38681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.