Healthcare Provider Details

I. General information

NPI: 1659234052
Provider Name (Legal Business Name): CORAZON HEALTH COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8435 RESEDA BLVD STE 101
NORTHRIDGE CA
91324-4625
US

IV. Provider business mailing address

14600 SHERMAN WAY STE 250
VAN NUYS CA
91405-2284
US

V. Phone/Fax

Practice location:
  • Phone: 818-998-6000
  • Fax: 818-818-6069
Mailing address:
  • Phone: 818-998-6600
  • Fax: 818-495-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SALOUMEH YARAGHCHI
Title or Position: PRACTICE MANAGER
Credential:
Phone: 310-709-6604