Healthcare Provider Details

I. General information

NPI: 1902651292
Provider Name (Legal Business Name): MVP MEDICAL GROUP-A PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 W BURBANK BLVD STE 105
BURBANK CA
91505-2348
US

IV. Provider business mailing address

3100 W BURBANK BLVD STE 105
BURBANK CA
91505-2348
US

V. Phone/Fax

Practice location:
  • Phone: 818-405-7764
  • Fax:
Mailing address:
  • Phone: 818-405-7764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MAYRANUSH ASLIBEKYAN
Title or Position: BUSINESS OWNER
Credential: NP
Phone: 818-405-7764