Provider Demographics
NPI:1316134455
Name:R. S. VASAN, MD., INC
Entity type:Organization
Organization Name:R. S. VASAN, MD., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:R
Authorized Official - Middle Name:S
Authorized Official - Last Name:VASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-782-4104
Mailing Address - Street 1:15211 VANOWEN ST ST. 201
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405
Mailing Address - Country:US
Mailing Address - Phone:818-782-4104
Mailing Address - Fax:818-782-0231
Practice Address - Street 1:15211 VANOWEN ST ST. 201
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405
Practice Address - Country:US
Practice Address - Phone:818-782-4104
Practice Address - Fax:818-782-0231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA33733Medicare PIN