Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A32942 | CA |
NPI | 1043305618 |
---|---|
Provider Name | Victor Vitaly Strelzow |
First Address | Irvine, CA 92618 |
Second Address | Irvine, CA 92618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A26983 | (02) | CA |