Unknown Individual – Internal Medicine Physician, NPI 1619966488

Unknown Individual is a healthcare provider. based in Tarzana, California. specializing in Internal Medicine Physician. They hold a License No. A19213 (CA). The NPI Number for Unknown Individual is 1619966488

Main info

Organization
Inactive
66 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1619966488
Phone
(818) 708-5855
Address
18370 BURBANK BLVD
Deactivation Date
29 September 2022

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Secondary Phone
8189964100
Graduation Year
1960 (66 years ago)
PAC ID
3072504935
Group Practice PAC ID
4284696600
Professional Enrollment ID
I20040519001358
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Burbank Boulevard, Tarzana, Los Angeles, Los Angeles County, California, 91316, United States

    401

    TARZANA, CA 913562804

    Phone: (818) 708-5855

    Fax: (818) 996-0842

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $171.

Total Amount is formed as General ($171) + Research ($0) + Ownership ($0) = $171.

Last reported payment date: 2024-05-24 • Largest payer in this snapshot: Abbott Laboratories ($171).

Total Amount

$171

General + Research + Ownership

Payments

7

Total payment records

General Amount

$171

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-24

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$171
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 91356)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)CA83036Hemoglobin A1C level14687

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1619966488 uniquely identifies Unknown Individual in U.S. healthcare data.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Tarzana, California in registry-derived data.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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