INNOVATIVE MEDICAL SOLUTIONS INC A MEDICAL GROUP NPI 1972624955

NPI Information

  • NPI: 1972624955
  • Provider Name: INNOVATIVE MEDICAL SOLUTIONS INC A MEDICAL GROUP
  • Classification: Internal Medicine - 207RA0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • CLIA Number: 05D2267988
  • Address: 14860 ROSCOE BLVD STE 200
    PANORAMA CITY, CA
    ZIP 91402
  • Phone: (310) 553-5203

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NPI Details

INNOVATIVE MEDICAL SOLUTIONS INC A MEDICAL GROUP is an adolescent medicine internal medicine in Panorama City, CA. The provider is an internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. INNOVATIVE MEDICAL SOLUTIONS INC A MEDICAL GROUP NPI is 1972624955. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

14860 ROSCOE BLVD STE 200
PANORAMA CITY, CA
ZIP 91402-683
Phone: (310) 553-5203

The provider's authorized official is Glenn A Marshak .
The authorized official title is Owner and has the following contact phone number (310) 553-5203.

The CLIA number assigned to this NPI record is 05D2267988 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 9/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RA0000XInternal MedicineAdolescent MedicineG78454CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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