Organization Name: | DAMG GROUP INC |
NPI Number: | 1679903207 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIKHAEL AKHONDI (CEO) |
Mailing Address: | 12826 Victory Blvd Ste 4 North Hollywood |
State: | CA US |
Postal Code: | 916063013 |
Phone Number: | 8186708990 |
Fax Number: | 8186708991 |
NPI Enumeration Date: | 11/18/2013 |
NPI Last Update Date: | 11/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A60601 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |