Roger L Novack, MD | |
1245 Wilshire Blvd, 380, Los Angeles, CA 90017-4810 | |
(213) 483-8810 | |
(213) 481-1503 |
Full Name | Roger L Novack |
---|---|
Gender | Male |
Speciality | Ophthalmology |
Location | 1245 Wilshire Blvd, Los Angeles, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104828706 | NPI | - | NPPES |
W3452 | Other | CA | MEDICARE PTAN |
00G537790 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | G53779 (California) | Primary |
Entity Name | Retina Vitreous Associates Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134164023 PECOS PAC ID: 5799769584 Enrollment ID: O20040617001206 |
Mailing Address | Practice Location Address |
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Roger L Novack, MD 1245 Wilshire Blvd, 380, Los Angeles, CA 90017-4810 Ph: (213) 483-8810 | Roger L Novack, MD 1245 Wilshire Blvd, 380, Los Angeles, CA 90017-4810 Ph: (213) 483-8810 |
Victoria Li-ting Tseng, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 200 Stein Plaza #1-340, Los Angeles, CA 90095 Phone: 310-825-5000 | |
Peter Dentone, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 200 Stein Plaza #1-340, Los Angeles, CA 90095 Phone: 310-825-5000 | |
Michael Myung-sup Han, Ophthalmology Medicare: Medicare Enrolled Practice Location: 1450 San Pablo St, Los Angeles, CA 90033 Phone: 323-442-6335 Fax: 714-456-8874 | |
Kristin Elizabeth Nesburn, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 8635 W 3rd Street, #390w, Los Angeles, CA 90048 Phone: 310-652-1133 Fax: 310-652-4353 | |
Dr. Stanley S. Kim, M.D. Ophthalmology Medicare: Medicare Enrolled Practice Location: 3663 W 6th St, Suite #200, Los Angeles, CA 90020 Phone: 213-385-8500 Fax: 213-385-4896 | |
Homayoun Tabandeh, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1245 Wilshire Blvd, 380, Los Angeles, CA 90017 Phone: 213-483-8810 Fax: 213-481-1503 | |
Arnold Barron, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 4733 W Sunset Blvd, Los Angeles, CA 90027 Phone: 323-783-4011 |