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AVANTA MEDICAL GROUP
NPI 1770429102
General Practice in Van Nuys, CA

Active since April 27, 2026
14649 VICTORY BLVD STE 22, VAN NUYS, CA 91411(818) 796-5558 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Avanta Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVANTA MEDICAL GROUP (NPI 1770429102) is a healthcare organization registered as a general practice in Van Nuys, California and active in the NPI registry since April 2026. The organization lists Vyacheslav Davtian, Ceo, as its authorized official.

NPPES Registry Identity

NPI1770429102
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameAVANTA MEDICAL GROUP
Location Address14649 VICTORY BLVD STE 22Van Nuys, CA 91411-4101
Mailing Address14649 Victory Blvd Ste 22Van Nuys, CA 91411-4101 · (818) 796-5558
Phone(818) 796-5558
Organization SubpartNo
Authorized OfficialVyacheslav DavtianCeo · (818) 796-5558
Enumeration DateApril 27, 2026
NPPES CertifiedApril 27, 2026
✔ NPI 1770429102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedRegistered Nurse · Infusion TherapyTaxonomy 163WI0500X
Also ListedRegistered Nurse · Pain ManagementTaxonomy 163WP0000X
Also ListedPodiatristTaxonomy 213E00000X
14649 VICTORY BLVD STE 22, Van Nuys, CA 91411
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avanta Medical Group's NPI number?

The NPI number for Avanta Medical Group is 1770429102. It was assigned to this organization in the NPPES registry on April 27, 2026.

Where is Avanta Medical Group located?

Avanta Medical Group is located at 14649 Victory Blvd Ste 22, Van Nuys, CA 91411. The listed phone number is (818) 796-5558.

What is Avanta Medical Group's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Avanta Medical Group was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.