Healthcare Provider Details

I. General information

NPI: 1265851471
Provider Name (Legal Business Name): KAMI ADIBI MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9064 VAN NUYS BLVD
PANORAMA CITY CA
91402-1813
US

IV. Provider business mailing address

9064 VAN NUYS BLVD
PANORAMA CITY CA
91402-1813
US

V. Phone/Fax

Practice location:
  • Phone: 310-717-5777
  • Fax:
Mailing address:
  • Phone: 310-717-5777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KAMI ADIBI
Title or Position: OWNER/DIRECTOR
Credential: M.D.
Phone: 310-717-5777