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Individual

SOFIA VAISMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
22600 VENTURA BLVD STE 101, WOODLAND HILLS, CA 91364-1430
(818) 225-1255
Mailing address
22600 VENTURA BLVD STE 101, WOODLAND HILLS, CA 91364-1430
(818) 225-1255

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A036979
CA
208D00000X
General Practice Physician
A036979
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A369790
CA
01
010017655
RAILROAD MEDICARE
CA
Enumeration date
09/27/2006
Last updated
02/19/2014
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