Unknown Individual – Internal Medicine Physician, NPI 1629073044
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Burbank Boulevard, Tarzana, Los Angeles, Los Angeles County, California, 91316, United States
STE 412
TARZANA, CA 913562831
Phone: (818) 401-1720
Fax: (818) 401-1739
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 22 Open Payments records for all available years, with a total value of $542.
Total Amount is formed as General ($542) + Research ($0) + Ownership ($0) = $542.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Mallinckrodt Hospital Products Inc. ($118).
Total Amount
$542
General + Research + Ownership
Payments
22
Total payment records
General Amount
$542
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 131 | 66 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 73 | 45 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 62 | 36 | $0 |
| G0008 | Administration of influenza virus vaccine | 18 | 18 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 14 | 14 | $0 |
Insurance plans in this area (ZIP 91356)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| Internal Medicine | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Internal Medicine | CA |
Reviews
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