Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | G56061 | CA |
NPI | 1407915150 |
---|---|
Provider Name | Steven A. Vasilev |
First Address | Encino, CA 91316-3599 |
Second Address | Santa Monica, CA 90404-2303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 21/06/2021 |