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Organization
LUTZ E VENTZKE MD A MEDICAL CORPORATION
Active
Organization
LUTZ E VENTZKE MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUTZ EBERHARD VENTZKE MD (PRESIDENT LUTZ E VENTZKE MD A MEDIC)
(818) 704-7248
Entity
Organization
Contact information
Practice address
7320 WOODLAKE AVE, SUITE 210, WEST HILLS, CA 91307-1483
(818) 348-3230
(818) 883-4496
Mailing address
22357 MULHOLLAND DRIVE, WOODLAND HILLS, CA 91364-4934
(818) 704-7248
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A17887
CA
207RG0100X
Gastroenterology Physician
A17887
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A178870
—
CA
01
—
05D0714631
CLIA NUMBER
—
01
—
WA17887A
PROVIDER NUMBER
—
Enumeration date
04/30/2007
Last updated
04/30/2008
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