Individual
MARK VAISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12660 RIVERSIDE DR, STE 310, NORTH HOLLYWOOD, CA 91607-3429
(818) 755-0391
(818) 753-8165
Mailing address
12660 RIVERSIDE DR, STE 310, NORTH HOLLYWOOD, CA 91607-3429
(818) 755-0391
(818) 753-8165
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A38899
CA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
A38899
CA
2085R0202X
Diagnostic Radiology Physician
A38899
CA
2085U0001X
Diagnostic Ultrasound Physician
A38899
CA
208D00000X
General Practice Physician
Primary
A38899
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A388990
—
CA
Enumeration date
11/15/2007
Last updated
02/08/2013
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