Healthcare Provider Details

I. General information

NPI: 1528992757
Provider Name (Legal Business Name): PHH-CALF-01
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N BRAND BLVD STE 600
GLENDALE CA
91203-2349
US

IV. Provider business mailing address

1250 W GLENOAKS BLVD STE E
GLENDALE CA
91201-2281
US

V. Phone/Fax

Practice location:
  • Phone: 818-476-4888
  • Fax:
Mailing address:
  • Phone: 818-476-4884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES HILL
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 941-323-9111