# MS VAISMAN MEDICAL SERVICES A PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1174624944
- **Authorized official:** DR. MARK VAISMAN MD (PRESIDENT CEO)
- **Authorized official phone:** (818) 506-6937

## Contact information

- **Practice address:** 11724 VENTURA BLVD, SUITE A, STUDIO CITY, CA 91604
- **Practice address phone:** (818) 506-6937
- **Practice address fax:** (818) 506-2594
- **Mailing address:** 11724 VENTURA BLVD, SUITE A, STUDIO CITY, CA 91604
- **Mailing address phone:** (818) 506-6937
- **Mailing address fax:** (818) 506-2594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A38899 | CA | — |
| 2085N0700X | Neuroradiology Physician | — | NULL | — |
| 2085N0700X | Neuroradiology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208D00000X | General Practice Physician | A38899 | CA | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 2278P1004X | Pulmonary Diagnostics Certified Respiratory Therapist | — | NULL | — |
| 2278P1004X | Pulmonary Diagnostics Certified Respiratory Therapist | — | — | — |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 09/22/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00A388990 | BLUE SHIELD | CA |
| 05 | — | 00A388990 | — | CA |
| 01 | — | 047692 | HEALTH NET | CA |
| 01 | — | 124100111 | PACIFICARE REGAL HMO | CA |
| 01 | — | 146780057 | PACIFICARE NIPA HMO | CA |
| 01 | — | 146970061 | PACIFICARE ST VINCENT | CA |
| 01 | — | 19190 | CARE 1ST HEALTH PLAN NOBL | CA |
| 01 | — | 206140013 | PACIFICARE PREMIER HMO | CA |
| 01 | — | 24013 | UHP | CA |
| 01 | — | 2840525 | AETNA HMO | CA |
| 01 | — | 3709552 | CIGNA PPO | CA |
| 01 | — | 3709552008 | CIGNA PREMIER HMO | CA |
| 01 | — | 4341338 | AETNA PPO | CA |
| 01 | — | DK033 | UNIVERSAL CARE | CA |