Organization Name: | CANOGA PARK URGENT CARE FAMILY MEDICINE |
NPI Number: | 1487913810 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SYRUS FERIDOUNI (PRESIDENT) |
Mailing Address: | 20905 Sherman Way Canoga Park |
State: | CA US |
Postal Code: | 913031743 |
Phone Number: | 8187444369 |
Fax Number: | 3104440606 |
NPI Enumeration Date: | 05/04/2012 |
NPI Last Update Date: | 05/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A92103 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |