Healthcare Provider Details

I. General information

NPI: 1598207144
Provider Name (Legal Business Name): COMPLETE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17777 VENTURA BLVD 100
ENCINO CA
91316-3736
US

IV. Provider business mailing address

17777 VENTURA BLVD SUITE 100
ENCINO CA
91316-3736
US

V. Phone/Fax

Practice location:
  • Phone: 818-796-4214
  • Fax:
Mailing address:
  • Phone: 818-796-4214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number30678
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number30678
License Number StateCA

VIII. Authorized Official

Name: ELENA JANEV
Title or Position: CEO/PRESIDENT
Credential:
Phone: 818-796-4214