# BORIS VAISMAN MEDICAL COPORATION

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

## Provider details

- **NPI number:** 1598911497
- **Authorized official:** DR. BORIS VAISMAN M.D. (CEO)
- **Authorized official phone:** (818) 225-1255

## Contact information

- **Practice address:** 22600 VENTURA BLVD STE 101, WOODLAND HILLS, CA 91364-1430
- **Practice address phone:** (818) 225-1255
- **Practice address fax:** (818) 225-8646
- **Mailing address:** 4932 CHIMINEAS AVE, TARZANA, CA 91356-4302
- **Mailing address phone:** (818) 225-1255
- **Mailing address fax:** (818) 225-8646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A92266 | CA | Yes |

## Other

- **Enumeration date:** 08/11/2008
- **Last updated:** 08/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2901737 | — | CA |