Healthcare Provider Details

I. General information

NPI: 1801604103
Provider Name (Legal Business Name): GMOMENTUM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6235 MORSE AVE
NORTH HOLLYWOOD CA
91606-2919
US

IV. Provider business mailing address

6235 MORSE AVE
NORTH HOLLYWOOD CA
91606-2919
US

V. Phone/Fax

Practice location:
  • Phone: 323-420-7777
  • Fax:
Mailing address:
  • Phone: 323-420-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. GOARIK MINASYAN
Title or Position: OWNER
Credential: NP
Phone: 323-420-7777