Organization Name: | COMPREHENSIVE COMMUNITY HEALTH CENTERS |
NPI Number: | 1386824688 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FLORA POLADYAN (COO) |
Mailing Address: | 801 S Chevy Chase Dr #20 Glendale |
State: | CA US |
Postal Code: | 912054431 |
Phone Number: | 8182652210 |
Fax Number: | 8182910291 |
NPI Enumeration Date: | 11/05/2007 |
NPI Last Update Date: | 11/05/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |