Healthcare Provider Details

I. General information

NPI: 1801700828
Provider Name (Legal Business Name): MG CLINICAL CONSULTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29178 BENTLEY WAY
CANYON COUNTRY CA
91387-4620
US

IV. Provider business mailing address

29178 BENTLEY WAY
CANYON COUNTRY CA
91387-4620
US

V. Phone/Fax

Practice location:
  • Phone: 818-384-4545
  • Fax:
Mailing address:
  • Phone: 818-384-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARINE GULOYAN
Title or Position: PRESIDENT
Credential: LCSW
Phone: 818-384-4545