# JACOB REZNIK MD, INC., A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043495724
- **Authorized official:** DR. JACOB REZNIK MD (OWNER)
- **Authorized official phone:** (310) 980-6037

## Contact information

- **Practice address:** 16055 VENTURA BLVD, \#690, ENCINO, CA 91436-2601
- **Practice address phone:** (818) 789-5558
- **Mailing address:** 8568 BURTON WAY, \#102, LOS ANGELES, CA 90048-3353
- **Mailing address phone:** (310) 980-6037

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | A101891 | CA | Yes |

## Other

- **Enumeration date:** 12/31/2007
- **Last updated:** 12/05/2008