| Prestige Medical Center | |
|
7855 Santa Monica Blvd West Hollywood CA 90046-5344 | |
| (310) 623-9222 | |
| (310) 921-5623 |
| Full Name | Prestige Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 7855 Santa Monica Blvd, West Hollywood, California |
| Authorized Official Name and Position | Vlad Nusinovich (PRESIDENT) |
| Authorized Official Contact | 3106239222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Medical Center 7855 Santa Monica Blvd West Hollywood CA 90046-5344 Ph: (310) 623-9222 | Prestige Medical Center 7855 Santa Monica Blvd West Hollywood CA 90046-5344 Ph: (310) 623-9222 |
| NPI Number | 1801045778 |
|---|---|
| Provider Enumeration Date | 09/15/2008 |
| Last Update Date | 05/14/2014 |
| Medicare PECOS PAC ID | 5496823833 |
|---|---|
| Medicare Enrollment ID | O20081013000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801045778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A92996 (California) | Primary |
| Provider Name | Vlad Nusinovich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144288036 PECOS PAC ID: 4981607736 Enrollment ID: I20080124000182 |
| Provider Name | Marina Vernaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457643611 PECOS PAC ID: 0749509818 Enrollment ID: I20150512002107 |
| Provider Name | Larisa Karazhova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144520388 PECOS PAC ID: 8527224914 Enrollment ID: I20211202001260 |
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