Provider Demographics
NPI:1972342764
Name:SAPOZHNIKOV MEDICAL CORPORATION
Entity type:Organization
Organization Name:SAPOZHNIKOV MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPOZHNIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-316-1200
Mailing Address - Street 1:10780 SANTA MONICA BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4779
Mailing Address - Country:US
Mailing Address - Phone:424-316-1200
Mailing Address - Fax:
Practice Address - Street 1:10780 SANTA MONICA BLVD STE 350
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4779
Practice Address - Country:US
Practice Address - Phone:424-316-1200
Practice Address - Fax:424-758-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty