| Eleonora Fedonenko Md And David Vizel Md A Professional Medical Co | |
|
6221 Wilshire Blvd Suite 312 Los Angeles CA 90048-5201 | |
| (323) 655-0990 | |
| Not Available |
| Full Name | Eleonora Fedonenko Md And David Vizel Md A Professional Medical Co |
|---|---|
| Speciality | Internal Medicine |
| Location | 6221 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Eleonora Fedonenko (SECRETARY) |
| Authorized Official Contact | 3236550990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eleonora Fedonenko Md And David Vizel Md A Professional Medical Co 6221 Wilshire Blvd Suite 312 Los Angeles CA 90048-5201 Ph: (323) 655-0990 | Eleonora Fedonenko Md And David Vizel Md A Professional Medical Co 6221 Wilshire Blvd Suite 312 Los Angeles CA 90048-5201 Ph: (323) 655-0990 |
| NPI Number | 1649212028 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 05/24/2023 |
| Medicare PECOS PAC ID | 9830126705 |
|---|---|
| Medicare Enrollment ID | O20050721000910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649212028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Eleonora Fedonenko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790721850 PECOS PAC ID: 2567360571 Enrollment ID: I20031229000953 |
| Provider Name | Mariana Fraiman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750371761 PECOS PAC ID: 0547342396 Enrollment ID: I20080131000639 |
| Provider Name | David Vizel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508809856 PECOS PAC ID: 9436225141 Enrollment ID: I20091010000000 |
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