Provider Demographics
NPI:1063302768
Name:RK MEDICAL CENTER
Entity type:Organization
Organization Name:RK MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSTAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHURSHUDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-434-0380
Mailing Address - Street 1:16200 VENTURA BLVD STE 227
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4662
Mailing Address - Country:US
Mailing Address - Phone:818-434-0380
Mailing Address - Fax:
Practice Address - Street 1:16200 VENTURA BLVD STE 227
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4662
Practice Address - Country:US
Practice Address - Phone:818-434-0380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty