Unknown Individual – Therapeutic Radiology Physician, NPI 1104923101
Therapeutic Radiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
VA Greater Los Angeles Healthcare System, 11301, Wilshire Boulevard, Veterans Administration, Los Angeles County, California, 90073, United States
LOS ANGELES, CA 900731003
Phone: (310) 268-3390
Type: Location
1665, Mandeville Canyon Road, Los Angeles, Los Angeles County, California, 90049, United States
LOS ANGELES, CA 900492523
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 90073)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | WI | |
| - | MN | |
| Family Practice, Emergency Medicine | MN | |
| - | MN | |
| Nurse Practitioner | MN | |
| - | AL | |
| P A T H O L O G Y | ND | |
| - | MN | |
| - | OK | |
| - | MN |
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