Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A141206 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A141206 | CA |
NPI | 1134396591 |
---|---|
Provider Name | Dr. Darko Vucicevic |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-5404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
717432 | (05) | AZ |