Organization Name: | SHERMAN BELL MEDICAL GROUP INC |
NPI Number: | 1669705919 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEROME E MCCUIN (OWNER/CEO) |
Mailing Address: | 12720 Sherman Way North Hollywood |
State: | CA US |
Postal Code: | 916055031 |
Phone Number: | 8189826000 |
Fax Number: | 8189826006 |
NPI Enumeration Date: | 09/17/2009 |
NPI Last Update Date: | 09/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C36270 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |