Provider Demographics
NPI:1144731092
Name:UNIVERSAL CARE MEDICAL GROUP
Entity type:Organization
Organization Name:UNIVERSAL CARE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:CATALINO
Authorized Official - Middle Name:
Authorized Official - Last Name:DUREZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-496-2411
Mailing Address - Street 1:10061 RIVERSIDE DR # 782
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2560
Mailing Address - Country:US
Mailing Address - Phone:661-496-2411
Mailing Address - Fax:
Practice Address - Street 1:10866 RIVERSIDE DR # 300
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-2236
Practice Address - Country:US
Practice Address - Phone:661-496-2411
Practice Address - Fax:818-980-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty